We present two cases of pneumatosis cystoides intestinalis (PCI) found by intraperitoneal free air.
Case 1: A 73-year-old woman was seen at the hospital because of right lower abdominal pain. Intraperitoneal free air was detected by chest and abdominal roentgenograms. Pneumatoid changes of the cecum, splenic flexure, descending and sigmoid colon were observed during laparotomy. Because of the risk of perforation ileocecal resection was carried out, but no evidence of perforated intestine was found.
Case 2: A 73-year-old woman with Parkinson's disease was seen at the hospital because of chest pain. Intraperitoneal free air was detected by chest roentgenogram, and abdominal CT scan demonstrated pneumatosis of the colonic wall. After the patient was treated with hyper oxygen, the intraperitoneal free air disappeared completely.
We concluded that abdominal CT scan should be employed for a patient without abdominal muscle guarding but with intraperitoneal free air by roentgenogram, and that hyper oxygen therapy should be the treatment of choise at first when the diagnosis is PCI.
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)