"Cystamatic" Review: Is Surgery Mandatory for Pneumatosis Cystoides Intestinalis?

Dig Dis Sci. 2019 Oct;64(10):2769-2775. doi: 10.1007/s10620-019-05767-4.


Introduction: Pneumatosis cystoides intestinalis (PCI) is a rare condition characterized by the presence of intramural gas cysts within the small and large intestines. We describe a case of a 70-year-old man admitted to the Emergency Surgery Department for PCI who was treated conservatively.

Areas covered: We reviewed 60 cases of PCI described in the international literature over the last 5 years. From our analysis, it appears that the etiology of the gas production within the submucosa or the subserosa of the gastrointestinal tract is still unknown. The rupture of the cysts can lead to pneumoperitoneum that can simulate a surgical emergency.

Expert commentary: For patients with PCI, a conservative approach is the treatment of choice, with surgery mandatory only for complicated disease.

Keywords: Conservative management; Pneumatosis cystoides intestinalis; Spontaneous pneumoperitoneum.

Publication types

  • Case Reports

MeSH terms

  • Abdomen, Acute / diagnosis*
  • Aged
  • Colonoscopy / methods
  • Conservative Treatment / methods*
  • Diagnosis, Differential
  • Humans
  • Male
  • Pneumatosis Cystoides Intestinalis* / complications
  • Pneumatosis Cystoides Intestinalis* / diagnosis
  • Pneumatosis Cystoides Intestinalis* / physiopathology
  • Pneumatosis Cystoides Intestinalis* / therapy
  • Pneumoperitoneum* / diagnostic imaging
  • Pneumoperitoneum* / etiology
  • Radiography, Abdominal / methods
  • Tomography, X-Ray Computed / methods*
  • Treatment Outcome
  • Unnecessary Procedures