Successful treatment of recurrent pneumatosis cystoides intestinalis in an alcoholic cirrhosis patient by oxygen supplementation via a nasal cannula

Abstract

Pneumatosis cystoides intestinalis (PCI) is a relatively rare disease characterized by multiple gas-filled cysts in the bowel wall. We report a rare case of recurrent PCI in a patient with alcoholic cirrhosis, who was successfully treated by oxygen supplementation via a nasal cannula. A 57-year-old female who was being followed up at our hospital for alcoholic cirrhosis presented with persistent abdominal pain. CT showed pneumatosis in the large intestinal wall, and PCI was diagnosed. Although her symptoms were mild at onset, they deteriorated 10 months later. The patient was admitted and treated by oxygen supplementation at 5 L/minute via a nasal cannula for one week, and her symptoms and intestinal pneumatosis disappeared. Although the PCI recurred four times in the subsequent 14 months and sometimes intraabdominal free air was seen, the oxygen supplementation via a nasal cannula (5 L/min×1 week) was always successful. Within one week, her symptoms, intestinal pneumatosis, and intraabdominal free air disappeared. Because oxygen supplementation via a nasal cannula is easy, safe and useful, it should be considered as the treatment of first choice for PCI. There are no reports yet of PCI in patients with alcoholic cirrhosis, and the relation between the PCI and liver disease in this patient remains uncertain.