Pneumatosis Cystoides Intestinalis after Laparoscopic Gastrojejunostomy—A Case Report—

Abstract

A 72-year-old man with unresectable duodenal cancer with vascular invasion underwent palliative laparoscopic gastrojejunostomy. Repeated vomiting was observed on postoperative day (POD) 3, followed by a high-grade fever of 39.7 °C on POD4. On POD6, abdominal computed tomography (CT) showed pneumatosis cystoides intestinalis (PCI) in the gastric wall accompanied by hepatic portal vein gas (HPVG) and intraperitoneal free air. Since there was no evidence of necrosis or peritonitis, the patient was managed conservatively with antibiotics and fasting. Liquid food and solid food intake were restarted on POD7 and POD9, respectively. After recovering, chemotherapy for duodenal cancer was started on POD23. To the best of our knowledge, this article describes the first case presenting with PCI accompanied by HPVG and free air after gastrojejunostomy.