A case of pneumatosis cystoides intestinalis involving the large intestine during therapy of interstitial pneumonia

Abstract

A 79-year-old woman with a diagnosis of interstitial pneumonitis eight months previous has continued a treatment with steroids and immunosuppressive drugs for the long term. She suffered an attack of abdominal pain in the right lower quadrant and abdominal fullness for a few hours. An abdominal computed tomography (CT) examination demonstrated pneumatosis coli from the ileocecal area to the descending colon, retroperitoneal emphysema and free air in the abdominal space.
We suspected perforation of the digestive tract and performed an emergency laparotomy. At the laparotomy, because we found some ascites including stool and the food residue and could not identify a perforated site anywhere in the entire gastrointestinal tract, we believe that the free air in the abdominal space occurred subsequent to interstitial pneumonia and then performed a drainage procedure.
We report a case of pneumatosis cystoides intestinalis (PCI) involving the large intestine during therapy of interstitial pneumonitis, and a review of the relevant literature.