Abstract
A 74-year-old woman was brought into our hospital because of abdominal distension after an enema administration. Abdominal CT scan showed free air, hepatic portal venous gas, and pneumatosis cystoides intestinalis in the wall of the small intestine. There were no apparent findings suggestive of intestinal necrosis and gastrointestinal perforation. The patient's condition improved through conservative therapy including withdrawal of an α-glucosidase inhibitor for diabetes. Recentely pneumatosis cystoides intestinalis caused by α-glucosidase inhibitors has sometimes been reported. We consider that an α-glucosidase inhibitor might induce pneumatosis cystoides intestinalis in this case. Abrupt elevation of the inner pressure in the intestine due to the enema might cause rupture of emphysema, transference of gas into the vessel, and resultant free air and hepatic portal venous gas.
