title: The dilemma of pneumatosis intestinalis with pneumoperitoneum: nonoperative or surgical management-analysis of a case.
abstract: Pneumatosis intestinalis (PI) is an uncommon condition and can be associated with a wide spectrum of diseases, ranging from life-threatening to innocuous conditions. We report the case of a 46-year-old women coming to our attention for an acute abdominal pain, nausea, vomiting, constipation, and increased inflammatory marks, with a CT showing pneumoperitoneum and pneumatosis intestinalis. The previous diagnosis was advanced neoplasia of unknown origin. Despite the surgical intervention, which excluded an ischemic colitis, the patient died in the early postoperative period. The postmortem diagnosis was carcinoma of thymus gland, and the presence of pneumatosis was put down to metastasis nodes in the pulmonary parenchima. This case demonstrates the wide spectrum of presentation of pneumatosis intestinalis, the importance of a careful radiologic evaluation beside the clinical history, since the identification of correct pathogenesis and treatment can be very difficult.
authors: Department of General Surgery, University Hospital of Udine, 33100 Udine, Italy.
authors: A
authors: A
authors: Rossetto
authors: M
authors: M
authors: Brizzolari
authors: E
authors: E
authors: Scarpa
authors: G
authors: G
authors: Terrosu
authors: V
authors: V
authors: Bresadola
references: J Surg Case Rep. 2010 May 01;2010(3):3
references: 24946173
references: J Gastrointest Surg. 2010 Mar;14(3):437-48
references: 20077158
references: Arch Surg. 2003 Jan;138(1):68-75
references: 12511155
references: Cases J. 2009 Aug 12;2:6452
references: 19918585
references: Scand J Surg. 2005;94(1):47-50
references: 15865117
references: Gynecol Oncol. 2005 Dec;99(3):782-4
references: 16169578
references: Eur J Med Res. 2009 Jun 18;14(6):231-9
references: 19541582
references: Ann Surg. 1990 Aug;212(2):160-5
references: 2375647
references: Clin Rheumatol. 2007 Apr;26(4):601-3
references: 16404494
references: Surgery. 2011 Feb;149(2):297-8
references: 19758671
references: J Gastroenterol Hepatol. 2012 Jan;27(1):182
references: 22188029
references: Case Rep Med. 2011;2011:571387
references: 21331331
references: AMA Arch Pathol. 1952 Jun;53(6):523-49
references: 14923068
references: Lancet. 1995 May 13;345(8959):1220-2
references: 7739311
references: World J Gastroenterol. 2011 Nov 28;17(44):4932-6
references: 22171137