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Pneumatosis cystoides intestinii

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Abstract

Pneumatosis cystoides intestinalis (PCI), a condition involving submucosal or subserosal gas-containing cysts of the wall of the gastrointestinal tract, is a rare entity. It is mostly diagnosed between the third and fifth decades of life without a clear sexual predominance. Different aetiopathogenetic factors are under discussion, the most probable being a bacteriologic cause (Clostridium perfringens) in combination with minimal leaks in mucosal barrier. There are no pathognomonic symptoms; the clinical picture ranges from incidental findings to haematochezia. Diagnosis is based on plain abdominal film and X-ray following barium enema. Methods of treatment in symptomatic cases are oxygen and antibiotic (metronidazole) therapies and, in severe cases, resection of the diseased part of the intestine.

Zusammenfassung

Die Pneumatosis cystoides intestinii (PCI), das Auftreten submuköser oder subseröser, gasgefüllter Zysten in der Wand des Gastrointestinaltrakts, tritt als seltene Erkrankung ohne eindeutige Geschlechtspräferenz vorwiegend in der 3. bis 5. Lebensdekade auf. Atiopathogenetisch werden unterschiedliche Faktoren diskutiert, am wahrscheinlichsten ist eine bakterielle Ursache (Clostridium perfringens) in Verbindung mit einer minimalen Unterbrechung der Mukosaintegrität. Eine pathognomonische Symptomatik gibt es nicht, das klinische Bild reicht von asymptomatischen Zufallsbefunden bis zur Hämatochezie. Die Diagnose wird durch den Nachweis der Gaseinschlüsse mittels Abdomenübersichtsaufnahme und Kolonkontrasteinlauf gestellt. Als Behandlungsmethoden für symptomatische Patienten stehen Sauerstofftherapie, Antibiotikagabe (Metronidazol) und in schweren Fällen die Resektion des betroffenen Darmabschnitts zur Verfügung.

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Authors and Affiliations

  1. Chirurgische Klinik der RWTH Aachen, Pauwelsstraße 30, D-52074, Aachen

    P. Bertram, K. -H. Treutner, G. Winkeltau, H. -J. Booß &  V. Schumpelick

  2. Klinik für Radiologische Diagnostik der RWTH Aachen, Aachen, Germany

    G. Staatz

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  1. P. Bertram
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  2. K. -H. Treutner
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  3. G. Winkeltau
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  4. H. -J. Booß
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  5. G. Staatz
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  6. V. Schumpelick
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Bertram, P., Treutner, K.H., Winkeltau, G. et al. Pneumatosis cystoides intestinii. Langenbecks Arch Chir 378, 249–254 (1993). https://doi.org/10.1007/BF00184367

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