Abstract
Pneumatosis cystoides intestinalis (PCI) is a rare condition associated with various diseases. Here we report a case of PCI that occurred during chemotherapy for leukemia. A 12-year-old boy, diagnosed with acute lymphoblastic leukemia, had undergone chemotherapy for 4 years including two rounds of bone marrow transplantation. He required continuous administration of predonisolone and tacrolimus because of severe graft-versus-host disease. At the age of 16 years, he presented with abdominal distention, and radiographic examinations revealed intramural pneumatosis extending from the ascending colon to the sigmoid colon. Although his abdomen was distended and tympanitic by percussion and his bowel peristalsis decreased, he had neither fever nor peritoneal signs. Meeting the diagnosis criteria of PCI, he underwent continuous high concentration oxygen inhalation therapy. The lesion disappeared in 7 days after diagnosis. We therefore suggest a therapeutic strategy (through a literature review in relation to the primary symptoms) for underlying diseases and treatments for PCI, although most cases of PCI may recover with conservative treatment. We emphasize the importance of making a correct diagnosis to avoid unnecessary surgery.
