Intestinal Cystic Pneumatosis Secondary to Antro-Pyloric Stenosis Discovered during a Suspicion of Peritonitis by Ulcerative Perforation: A Case Report

Hajri Amal

Hassan 2University, Medicine and Pharmacy Faculty, Casablanca, Morocco and Department of General Surgery, Ibn Rochd-Casablanca University Hospital, Morocco and Service of Digestive Cancer Surgery and Liver Transplant, Aile III, Ibn Rochd-Casablanca University Hospital Center, Morocco.

Ettaoussi Abdelhak

Hassan 2University, Medicine and Pharmacy Faculty, Casablanca, Morocco and Department of General Surgery, Ibn Rochd-Casablanca University Hospital, Morocco.

Tijani Nissrine *

Hassan 2University, Medicine and Pharmacy Faculty, Casablanca, Morocco and Department of General Surgery, Ibn Rochd-Casablanca University Hospital, Morocco.

Bouali Mounir

Visceral Emergency Service, Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco and Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco.

El Bakuri Abdelilah

Visceral Emergency Service, Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco and Visceral Emergency Service, Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco.

El hattabi Khalid

Visceral Emergency Service, Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco and Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco.

Bensardi Fatima-zahra

Visceral Emergency Service, Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco and Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco.

Fadil Abdelaziz

Visceral Emergency Service, Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco and Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco.

*Author to whom correspondence should be addressed.


Abstract

Cystic intestinal pneumatosis is the presence of gas bubbles in the wall and the serosa of the digestive tract. It is a benign and rare pathology, of radiological diagnosis by abdominal CT given its great sensitivity and of favourable evolution by the spontaneous disappearance of the cysts and whose treatment would rather be abstention. We report the case of a 54-year-old man, a chronic smoker treated in 2019 for helicobacter pylori gastritis. He was hospitalized for vomiting associated with generalized abdominal pain with epigastric origin. the patient underwent an abdominal CT scan which found pneumo peritoneum, fairly abundant fluid intraperitoneal effusion and a stasis stomach. The patient was operated on and exploration revealed moderately abundant ascites, stasis of the stomach upstream of an intro-pyloric subtending stricture and intestinal cystic pneumatosis at the level of the last ileal loops. A gastro-jejunal diversion on a loop mounted in omega trans and under mesocolic with hail and hail anastomosis at the foot of the year was performed. The postoperative follow-up was simple.

Keywords: Cystic pneumatosis, antro-pyloric stenosis, diagnosis, treatment


How to Cite

Amal , Hajri, Ettaoussi Abdelhak, Tijani Nissrine, Bouali Mounir, El Bakuri Abdelilah, El hattabi Khalid, Bensardi Fatima-zahra, and Fadil Abdelaziz. 2023. “Intestinal Cystic Pneumatosis Secondary to Antro-Pyloric Stenosis Discovered During a Suspicion of Peritonitis by Ulcerative Perforation: A Case Report”. Asian Journal of Case Reports in Surgery 6 (2):395-99. https://journalajcrs.com/index.php/AJCRS/article/view/440.


References

Wu LL, Yang YS, Dou Y, Liu QS. A systematic analysis of pneumatosis cystoids intestinalis. World J Gastroenterol. 2013;19(30):4973-8. DOI: 10.3748/wjg.v19.i30.4973 PMID: 23946603; PMCID: PMC3740428.

Berritto D, Crincoli R, Iacobellis F, Iasiello F, Pizza NL, Lassandro F, Musto L, Grassi R. Primary pneumatosis intestinalis of small bowel: A case of a rare disease. Case Rep Surg. 2014;2014:350312.

DOI: 10.1155/2014/350312 Epub 2014 Nov 17. PMID: 25478280; PMCID: PMC4248370.

Zhang J. Pneumatosis cystoides intestinalis: six case reports and a review of the literature. BMC Gastroenterology. 2018;18(1):1-8.

Duvernoy JG. Anatomical observation of air trapped under the outer and inner skin of the intestines. Phys Med Abhandl Acad Wisseusch Petersb. 1783;2:182.

Pavic M, Debourdeau P, Ehre P, Billaud Y. Intestinal pneumatosis: Right colonic cystic form with a linear appearance on CT scan. Med Press. 2002;31(21):973-5.

Chan Sui Ko A, Brault C, Medioni L, Hakim S, Duhaut P, Schmidt J, A chance discovery of pneumoperitoneum: intestinal cystic pneumatosis', La Revue de Médecine Interne, 78th French Congress of Internal Medicine, Grenoble. 2018;39.

Miguil MS, Iben Loualid Y, Yila A, Lammat H, Rabbani K, Louzi A. Cadi Ayyad University Visceral Surgery Service', International Journal of Advanced Research. 2022;10(11):874–78.

El Matiallah, Mohammed Amine, Hicham El Bouhaddouti, Ouadii Mouaqit, El Bachir Benjelloun, Abdelmalek Ousadden, and Khalid Ait Taleb, 'Intestinal Cystic Pneumatosis Revealed by Gastro-Jejunal Anastomosis Stenosis: About a Case', The Pan African Medical Journal. 2013;15:125.

Intestinal Cystic Pneumatosis Secondary to Peptic Ulcer: About Three Cases' Available:https://www.panafrican-med-journal.com/content/article/20/150/full/> [Accessed 30 May 2023].

Soyer P, Martin-Grivaud S, Boudiaf M, Malzy P, Duchat F, Hamzi L. 'Linear or cystic: An iconographic review of CT aspects of pneumatosis intestinalis of the 'adult', Journal of Radiology. 2008;89(12): 1907–20

Foessel L, Faucher V, Lujic M, Charton J, Jeung MY, Roy C. ‘Overview of pneumatosis intestinalis. Feuillets de Radiologie. 2015;55(2).