A CASE OF PNEUMATOSIS CYSTOIDES INTESTINALIS IN THE COLON COMBINED WITH MULTIPLE GASTRIC CANCER

• Published in: Japanese Journal of National Medical Services Vol. 44; no. 4; pp. 412 - 415
• Main Authors: SUGIYAMA, Shunji, HIDAKA, Reiichiro, SUZUKI, Minoru, SAITSU, Hideki, HARAGUCHI, Shuichi, YOSHIDA, Koji, NONAKA, Michiyasu, SUGIHARA, Shigetaka, NAKAO, Tetsuji, ARITAKA, Tomoki
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of National Medical Services 1990; 一般社団法人 国立医療学会
• Subjects: gastric cancer; operation; pneumatosis cystoides intestinalis; pneumatosis cystoides intestinalis of the colon; 大腸腸管嚢腫様気腫; 手術; 胃癌; 腸管嚢腫様気腫
• ISSN: 0021-1699; 1884-8729
• DOI: 10.11261/iryo1946.44.412

Pneumatosis cystoides intestinalis is a rare disease with multiple cystoma containing gas seen under the mucosa or serous membrane of the intestinal tract. We recently experienced such a case combined with multiple gastric cancer, on which a report is pre-sented as follows. The case was a 74-year-old female with the chief complaint of loss of weight and epigastric discomfort. She was first seen in the Department of Gastrointestinal Medicine of our hospital for close examination, which led to the diagnosis of multiple gastric cancer (Borrmann type II on the greater curvature in the antrum and type II-C on the lesser curvature in the body of the stomach). This brought her to the Department of Surgery of our hospital for hospitalization. In the course of the operation, besides the gastric cancer, many bulging phymas were found in the ascending colon by palpation and endoscopy revealed a large number of pathological changes with hemispherical bulges of various sizes, some of which were found united with one another. The surfaces were smooth with hemorrhages in part but otherwise were covered with normal mucosa. Since pneumatosis cystoides intestinalis was suspected, we reexamined the preoperative plain roentgenogram of the abdomen to find pneumatic cysts on the intestinal wall as a shadow appearing like a grape cluster at the site of the pathological changes in the right lower abdomen, which proved our suspicion to be the right diagnosis. The operation performed involved subtotal gastrectomy and partial resection of the ascending colon. There have been a number of reports giving gastric or duodenal ulcer or association of trichloroethylene as the cause of this disease but we could not definitely identify the cause of the disease in our case. In this case we happened to find out the identity of the disease involved in the course of the operation. The fact that the transparent picture of the gas in the shape of a cluster of plenty grapes on the preoperative plain roentgenogram of the abdomen served as an important clue to the diagnosis of the above-mentioned disease was considered to imply that careful observation should have been made preoperatively in this case.