Pneumonatosis coli: report of two cases

Pneumatosis cystoides intestinalis (PCI)

Pneumatosis cystoides intestinalis (PCI) is a rare disease usually occurring in association with a large variety of gastrointestinal (GI) and non GI conditions in the majority of cases, although idiopathic PCI is also known to occur. There are two theories regarding the development of these intramural gas cysts--the mechanical and bacterial theories. PCI usually runs a benign course, although fulminant PCI can be present both in infants and adults. The importance of this condition for the surgeon lies in its early recognition, in order to prevent unnecessary surgical intervention, especially when pneumoperitoneum without clinical evidence of peritonitis is encountered. Oxygen therapy has been shown to lead to regression of PCI, although recurrences have been reported. Elemental diets and antimicrobial agents have provided symptomatic relief in a few reported cases. The association of PCI with a wide variety of conditions leads us to conclude that PCI may not be a disease in itself, but a sequel to these varied conditions.

Pneumatosis coli complicating carcinoma of the colon. Report of a case

The management of pneumatosis coli by oxygen therapy is now well established. In one of five patients treated by this method, routine colonoscopy after such therapy revealed a previously unsuspected carcinoma of the sigmoid colon. The need to thoroughly examine the colon after oxygen treatment to rule out coexistent pathologic conditions is emphasized.

Pneumatosis coli: case report documenting time from X-ray appearance to onset of symptoms

Pneumatosis coli was diagnosed in a 66-year-old atopic woman with a 6-month history of chronic cough and intermittent wheeze. A sequence of chest x-rays demonstrated the appearance of gas-filled cysts in the splenic flexure of the colon approximately 2 months before the development of bowel symptoms. The pneumatosis coli and symptoms disappeared in 6 days with the administration of oxygen at a flow rate of 6 liters/min by nasal prongs. The case demonstrates the slow progression of the condition from x-ray recognition to development of symptoms and the simple, effective treatment of the condition with nasal oxygen.