2007 Volume 10 Issue 2 Pages 116-121
Pneumatosis cystoids intestinalis (PCI) is characterized by the presence of gas retention within the submucosal or subserosal layer of the intestinal wall. An 18-year-old female with anorexia nervosa had severe abdominal distension without tenderness. She had suffered from an eating disorder attended with self-induced vomiting and secondary amenorrhea. In addition, she had suffered from obstinate constipation and hypothyroidism. Abdominal radiography and abdominal computed tomography showed intra-abdominal free air and lineal gas within the intestinal wall from the ascending colon to the hepatic flexure. She was diagnosed as having PCI at a neighborhood hospital and was admitted to our hospital for hyperbaric oxygen therapy (HBO) . We treated her with HBO (2 atm absolute) five days per week, 170 minutes each day, during bed rest and fasting. Her general condition improved, and diet was started on day 5 after admission. On abdominal radiography her PCI improved, and she was discharged on day 16 after admission. Following discharge, we continued to treat her with HBO five days per week, but reduced the sessions to 85 minutes each day. A month after the first HBO treatment her PCI had healed. The etiology of the PCI in this case seems to have been luminal pressure caused by obstinate constipation and self-induced vomiting.
