7148 Two young patients with a primary form of pneumatosis cystoides intestinalis.

Abstract

Pneumatosis cystoides intestinalis (PCI) is a rare condition characterized by the presence of submucosal or subserosal gas-filled cysts within the bowel wall. From 1985, we have observed five cases of PCI; we present two of these cases, that can be considered atypical in some way. In the first patient, a 20-year-old white male, disease was localized to the right colon. He had a history of chronic abdominal pain, with no findings at physical examination. A colonoscopy showed the presence of multiple rounded bluish masses in the right colon; puncture of these polypoid lesions with an endoscopic injection needle caused them to collapse, so confirming the diagnosis.A barium enema was then performed, with final definition of the case. An accurate evaluation excluded any associated condition and patient received no specific therapy. Three months later, follow-up endoscopy documented a complete resolution of the lesions. The second patient, a 23- year-old female, presented a disease localized to the left colon. She was referred for a recent history of abdominal pain and change in bowel habits; for this reason, patient underwent a colonscopy showing the presence of multiple typical lesions of PCI in the descending-sigmoid colon. Again, no associated condition was found. Follow-up endoscopy, performed after four months, revealed disappearance of gas collections without specific treatment. We conclude that the peculiarity of these two cases of PCI consists in the following aspects: 1)appearance in young patients; 2)absence of associated conditions (primary or idiopathic form); 3)differential diagnosis with inflammatory bowel disease; 4)spontaneous and rapid resolution of lesions.