Dysplasia in perforated intestinal pneumatosis complicating a previous jejuno-ileal bypass: A cautionary note

Figure 1 Unenhanced CT scan, showing the presence of multiple gas-filled parietal cysts and huge pneumoperitoneum.

Figure 2 Intraoperative view of dilated and inflamed defunctionalized jejunal loop, with fibrous peritonitis. No clear evidence of enteric or biliary contamination was present.

Figure 3 Pathological findings. A and B: Macroscopic appearance of surgical specimen with the typical cysts at different magnifications; C and D: Submucosal cysts (C, HE, × 20) lined by giant cells (D, HE, × 100).

Figure 4 Histological appearance and immunohistochemical staining. A: Focal area of mild dysplasia (HE, × 60); B: Positivity for P53; C: P16.