title: Pneumatosis intestinalis due to gastrointestinal amyloidosis: A case report & review of literature.
abstract: BACKGROUND
  Pneumatosis intestinalis (PI) is not a disease but a radiological finding with a poorly understood pathogenesis. It can be divided into primary/idiopathic (15%) or secondary (85%) Kim et al. 2007, based on the factors thought to play a role in its development. Amongst the rare causes of secondary PI is gastrointestinal (GI) amyloidosis.
  
  
  METHODS
  We report a case of a 46-year-old gentleman who presented with a one month history of acute on chronic abdominal pain, associated with one episode of melena. Upon further investigation, he was found to have pneumoperitoneum. He was taken to the operating theatre, where he was noted to have features of pneumatosis intestinalis of the small bowel with no evidence of bowel perforation. Postoperatively, he underwent an upper GI endoscopy with biopsies that revealed GI amyloidosis.
  
  
  CONCLUSIONS
  One of the rare causes that can lead to secondary PI is GI amyloidosis as proven in our case. Patients with symptomatic gastrointestinal amyloidosis usually present with one of four syndromes: gastrointestinal bleeding, malabsorption, protein-losing gastroenteropathy, and, less often, gastrointestinal dysmotility.
  
  
  CONCLUSIONS
  GI amyloidosis is a rare cause of secondary pneumatosis intestinalis. The presentation of the disease varies from patient to patient, therefore, the management should be tailored accordingly.
authors.affiliation: General surgery department, Rashid hospital, Dubai Health Authority, Dubai, UAE. Electronic address: filza.khalid88@gmail.com.
authors.forename: Filza
authors.initials: F
authors.lastname: Khalid
authors.affiliation: General surgery department, Rashid hospital, Dubai Health Authority, Dubai, UAE.
authors.forename: Hadiel
authors.initials: H
authors.lastname: Kaiyasah
authors.affiliation: General surgery department, Rashid hospital, Dubai Health Authority, Dubai, UAE.
authors.forename: Wafa
authors.initials: W
authors.lastname: Binfadil
authors.affiliation: General surgery department, Rashid hospital, Dubai Health Authority, Dubai, UAE.
authors.forename: Maiyasa
authors.initials: M
authors.lastname: Majid
authors.affiliation: General surgery department, Rashid hospital, Dubai Health Authority, Dubai, UAE.
authors.forename: Wessam
authors.initials: W
authors.lastname: Hazim
authors.affiliation: General surgery department, Rashid hospital, Dubai Health Authority, Dubai, UAE.
authors.forename: Yousif
authors.initials: Y
authors.lastname: ElTayeb
keywords: Endoscopy; Gastrointestinal amyloidosis; Laparotomy; Melena; Pneumatosis intestinalis; Pneumoperitoneum