DOI: 10.36347/sasjs.2021.v07i04.012

Pages: 207-209

Pneumatosis cystoides intestinalis (PCI) is low incidence disease, with atypical symptoms and imaging manifestations making it hard to diagnose. It is characterized by the presence of gas in the mucosa or submucosa of the digestive tract [1]. Its pathogenesis remains unclear; however, three theories have been accepted: the mechanical theory [2], the pulmonary theory [1] and the bacterial theory [3, 4]. Pneumoperitoneum caused by ruptured serosal cyst(s) of PCI is a rare but ‘‘benign” entity in the emergency setting that can be managed conservatively [5]. Here we present a case of 50-year-old male admitted to the emergency department with acute upper abdominal pain, with signs of bowel obstruction. CT scan showed indirect signs of mesenteric ischemia with an intraperitoneal free air. Patient was admitted to the operating room on the same day, and the examination revealed multiple cysts on the subserous of the small intestine. No intestinal perforation was diagnosed thus we opted for a therapeutic abstention. PCI’s prognosis is optimistic. Therefore, clinicians should increase their awareness of PCI to avoid unnecessary misdiagnosis. Surgery is only recommended when complications are suspected.