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Revista de la Facultad de Medicina
Print version ISSN 0120-0011
Abstract
MANRIQUE-MENDOZA, Alexis René; ECHAVARRIA-CADENA, Angie Marcela; PEREZ-BECERRA, Nathalia María and GARAVITO-CASTELLANOS, Mónica Natalia. Pneumatosis Intestinalis: A rare intraoperative finding. rev.fac.med. [online]. 2017, vol.65, n.4, pp.687-691. ISSN 0120-0011. https://doi.org/10.15446/revfacmed.v65n4.59471.
Introduction:
Pneumatosis intestinalis (PI) is a rare entity characterized by the presence of gas in the intestine wall, which is usually diagnosed as an incidental radiological finding.
Clinical case:
This paper reports the case of a 63-year-old patient with a history of chronic epigastralgia, who consulted due to a clinical picture of 1 week of evolution consisting of diffuse abdominal pain associated with abdominal distension, anorexia, emesis and diarrhea. Physical examination revealed a distended, tympanic abdomen, painful on palpation, with decreased bowel sounds and no signs of peritoneal irritation. A simple abdominal radiograph was performed, showing overdistension of intestinal loops, air-fluid levels, absence of distal gas and pneumoperitoneum. The patient was taken to exploratory laparotomy, where severe PI was observed in the final 100cm of the ileum.
Discussion:
PI, especially the cystic variant, is a rare pathology, with only 565 cases described worldwide and 6 in Latin America. This condition may go unnoticed due to its difficult diagnosis. Although diagnosis is considered to be radiological, 40% of the cases are found during surgery, as was the case of this patient. Surgical indication for this case was pneumoperitoneum, the most common complication (51%).
Keywords : Pneumatosis cystoides intestinalis; Pneumoperitoneum; Surgery; Radiology (MeSH).