J Rheum Dis.  2015 Aug;22(4):238-241. 10.4078/jrd.2015.22.4.238.

A Case of Pneumatosis Cystoides Intestinalis in a Patient with Dermatomyositis

• Go DJ
• Lee JS
• Joo SH
• Moon J
• Lee JH
• Lee EY

• KMID: 2222854
• DOI: http://doi.org/10.4078/jrd.2015.22.4.238

Abstract

Pneumatosis cystoides intestinalis (PCI), the presence of air within the bowel wall, could be complicated with connective tissue disease. PCI associated with dermatomyositis has rarely been reported. Here, we report on a case of PCI that occurred in a 60-year-old female patient with dermatomyositis, presenting with epigastric discomfort. PCI with pneumoperitoneum was detected on abdominal computed tomography but improved by conservative management without surgery. Treatment for secondary PCI is associated with underlying disease. Also, identification of serious complication, such as bowel perforation, necrosis, and peritonitis, requiring surgical intervention is important.

Keyword

Pneumatosis cystoides intestinalis; Dermatomyositis; Corticosteroids

MeSH Terms

Adrenal Cortex Hormones
Connective Tissue Diseases
Dermatomyositis*
Female
Humans
Middle Aged
Necrosis
Peritonitis
Pneumatosis Cystoides Intestinalis*
Pneumoperitoneum
Adrenal Cortex Hormones

Figure

• 

  Figure 1. Abdominal radiography and computed tomography (CT) scan at admission. (A) Abdominal radiography showed linear and cystic air collections in the bowel wall (arrows). (B) Abdominal CT scan revealed several intramural air-filled cysts involving throughout the small bowel (arrows). (C) Multiple small-size free air bubbles were observed in the abdominal cavity, suggesting small bowel micro-perforation (arrows).

• 

  Figure 2. Abdominal computed tomography (CT) scan after 20 days from admission. Pneumatosis intestinalis was resolved, and intra-abdominal free air disappeared. Mild wall thickening, implying non-specific enteritis, was remained but improved comparing with previous CT scan.

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