Pneumatosis cystoides intestinalis causing pneumoperitoneum in a patient administered an α-glucosidase inhibitor

Abstract

An 82-year-old woman who had been administered an α-glucosidase inhibitor for diabetes consulted our hospital complaining of nausea and vomiting. Her abdomen was soft, and there was no abdominal tenderness. A plain chest X-ray and contrast-enhanced abdominal CT revealed pneumatosis cystoides intestinalis (PCI) with free air. The patient was treated conservatively with “nil by mouth”, hydration, and oxygen supplementation, which led to improvement of the symptoms. Although PCI with pneumoperitoneum caused by the administration of an α-glucosidase inhibitor is extremely rare, gastrointestinal perforation should be excluded in such patients and careful observation is required.