A case of pneumatosis cystoides intestinalis diagnosed during laparoscopic exploration

Abstract

We report a case of pneumatosis cystoides intestinalis diagnosed during laparoscopic exploration. A 42-year-old woman underwent bone marrow transplantation for aplastic anemia when she was 23 years old ; she underwent chemo-radiation therapy and on esophagectomy for esophageal cancer at 35 years of age, and chemo-radiation therapy for tongue cancer at 42 years of age. She was admitted for resection of lymph node metastasis from the tongue cancer and developed abdominal pain following admission. Abdominal CT demonstrated free air around the liver. We performed laparoscopic exploration to rule out intestinal perforation although she did not have abdominal tenderness on examination. Laparoscopic exploration disclosed extensive pericolic gas around the transverse colon. It was determined that she had developed pneumatosis cystoides intestinalis 19 years after bone marrow transplantation and 7 years after chemo-radiation therapy. There may an association between her medical history and the subsequent development of pneumatosis cystoides intestinalis.