A Case of Systemic Sclerosis Diagnosed After the Patient Presented with Pneumatosis Cystoides Intestinalis

Abstract

The patient was a 60-year-old woman who presented to the hospital with the chief complaint of abdominal bloating. She had no abdominal pain, and blood tests showed no evidence of an inflammatory reaction. A contrast-enhanced CT of the abdomen revealed multiple pneumatoses in the intestinal wall and intraperitoneal free gas on the surface of the liver. However, owing to the absence of any other evidence of generalized peritonitis, we opted for conservative treatment rather than emergency surgery. Fiberoptic upper gastrointestinal endoscopy and colonoscopy revealed no mucosal lesions. The patient also exhibited Raynaud’s phenomenon and worsening of lower limb edema over time and further investigations led to the diagnosis of systemic sclerosis. Herein, we report a case of systemic scleroderma that remained undiagnosed until the patient presented with pneumatosis cystoides intestinalis.