| disease | Pneumatosis Cystoides Intestinalis |
| alias | Emphysema, Pneumocystis Disease, Pneumocystis Enterica, Pneumocystis Enterica, Duvernoy Syndrome, Cystic Lymphemphysema |
Pneumatosis cystoides intestinalis (Duvernoy) syndrome refers to the presence of multiple small gas-filled cysts of varying sizes beneath the intestinal mucosa or serosa, resembling polyps in appearance. Hence, it is also known as intestinal pneumatosis, cystic pneumatosis of the intestine, cystic lymphopneumatosis, or pneumatosis peritonealis.
bubble_chart Pathogenesis
The cause of pneumatosis cystoides is unclear. Under conditions of increased intraluminal pressure, gas in the intestine enters the intestinal wall through ulcers or ruptures along tissue spaces. Low-virulence gas-producing bacteria enter the lymphatic vessels from the intestinal mucosa, multiply, and produce gas, forming pneumatosis. The cysts resemble polyps or lymphangiomas in appearance, with a honeycomb-like cross-section. The cysts are surrounded by connective tissue and do not communicate with the intestinal lumen.
bubble_chart Clinical Manifestations
The clinical symptoms are mild and may include lower abdominal pain, mucous soft stools, diarrhea, and possibly gas bubbles. It can lead to gastrointestinal bleeding, intestinal obstruction, intestinal volvulus, and pneumoperitoneum.
bubble_chart Auxiliary Examination
1. The direct signs of X-ray include the double edge sign along the intestinal wall, or gas bands along the long axis of the intestine, or scattered localized round gas shadows of an abdominal mass.
2. After barium filling, there may be cystic translucent areas of varying sizes along the intestinal wall or within the lumen. Indirect signs may include pneumoperitoneum, pneumomediastinum, interposed small intestine, or colon.
3. Fiberoptic colonoscopy may reveal round, pale blue polypoid soft tissue masses protruding into the lumen. Biopsy may result in gas expulsion and cyst collapse.
bubble_chart DiagnosisClinical manifestations, X-ray examinations, fiberoptic colonoscopy, and biopsy, along with the observation of gas expulsion and cyst collapse, all contribute to the diagnosis.
bubble_chart Treatment Measures
For diseases related to treatment, hyperbaric oxygen therapy may be used. Surgical removal can be performed for severe patients or those with serious complications, but recurrence is likely.
