Abstract
A 78-years-old man visited to our hospital complaining of bloody stools. Plain X-ray of the abdomen showed multiple radiolucent clusters in the right lower abdomen and multiple submucosal tumor-like, smooth and elastic-soft hemispherical elevated lesions were seen through the sigmoidscopy. Barium enema revealed multiple gas cysts in the sigmoid colon, and we could diagnose this case as pneumatosis cystoides intestinalis with these findings. We performed endoscopic ultrasonography (EUS) to evaluate the location of gas cysts in the colon wall, and the high echoic lesions with acoustic shadows were seen in the submucosal layer. After admission, the symptoms were gradually relieved. The sigmoidscopy showed multiple gas cysts disappearing with erosion and bleeding on the top. Multiple radiolucent clusters were also disappeared on the plain X-ray of the abdomen at that time. Over these endoscopic findings through this clinical course, we concluded that gas cysts were ruptured spontaneously, and bloody stools were possibly due to bleeding from the top of gas cysts.
