Brief Article
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World J Gastroenterol. Aug 14, 2013; 19(30): 4973-4978
Published online Aug 14, 2013. doi: 10.3748/wjg.v19.i30.4973
A systematic analysis of pneumatosis cystoids intestinalis
Li-Li Wu, Yun-Sheng Yang, Yan Dou, Qing-Sen Liu
Li-Li Wu, Yun-Sheng Yang, Yan Dou, Qing-Sen Liu, Department of Gastroenterology and Hepatology, Chinese People’s Liberation Army Genaral Hospital, Beijing 100853, China
Author contributions: Wu LL and Yang YS contributed substantially to the conception and design of the data, drafted the paper and approved the version to be published; Wu LL, Dou Y and Liu QS contributed substantially to the analysis and interpretation of the data and approved the version to be published.
Correspondence to: Yun-Sheng Yang, MD, PhD, Department of Gastroenterology and Hepatology, Chinese People’s Liberation Army Genaral Hospital, Fuxing Road 28, Beijing 100853, China.
Telephone: +86-10-5549-9007 Fax: +86-10-5549-9007
Received: December 18, 2012
Revised: April 11, 2013
Accepted: June 28, 2013
Published online: August 14, 2013

AIM: To increase the understanding, diagnosis and treatment of pneumatosis cystoides intestinalis (PCI) and to find the characteristics and potential cause of the disease in China.

METHODS: We report here one case of PCI in a 70-year-old male patient who received a variety of treatment methods. Then, we systematically searched the PCI eligible literature published from an available Chinese database from May 2002 to May 2012, including CBM, CBMDisc, CMCC, VIP, Wanfang, and CNKI. The key words were pneumatosis cystoides intestinalis, pneumatosis, pneumatosis intestinalis, pneumatosis coli and mucosal gas. The patients’ information, histories, therapies, courses, and outcomes were reviewed.

RESULTS: The study group consisted of 239 PCI cases (male:female = 2.4:1) from 77 reported incidents. The mean age was 45.3 ± 15.6 years, and the median illness course was 6 mo. One hundred and sixty patients (66.9%) were in high altitude areas. In addition, 43.5% (104/239) of the patients had potential PCI-related disease, and 16.3% had complications with intestinal obstruction and perforation. The most common symptom was abdominal pain (53.9%), followed by diarrhea (53.0%), distention (42.4%), nausea and vomiting (14.3%), bloody stool (12.9%), mucous stool (12.0%) and constipation (7.8%). Most multiple pneumocysts developed in the submucosa of the colon (69.9%). The efficacy of the treatments by combined modalities, surgery, endoscopic treatment, conservative approach, oxygen, and antibiotics were 100%, 100%, 100%, 93.3%, 68.3% and 26.3%, respectively.

CONCLUSION: PCI can be safely managed by conservative treatments, presents more frequently in males, in the large bowel and submucosa, than in females, in the small intestine and subserosa. High altitude residence maybe associated with the PCI etiology.

Keywords: Pneumatosis cystoides intestinalis, Pneumatosis, Cyst, Intestinal, Colon

Core tip: Pneumatosis cystoids intestinalis (PCI) is a rare disease characterized by the presence of multiple gas-filled cysts in the submucosa and/or subserosa of the intestinal wall. PCI is still a poorly understood entity, and nearly all of the studies for PCI are case reports. In this work, we systematically evaluated and demonstrated for the first time the characteristics of PCI patients in China.