Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
권호 표지

A Case of Pneumatosis Cystoides Intestinalis in Which Endoscopic Ultrasonography Was Useful for the Diagnosis

내시경 초음파로 진단한 낭성 장기종 1예

  • Kang, Eun-Jung (Department of Internal Medicine, Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University College of Medicine) ;
  • Kim, Jin-Oh (Department of Internal Medicine, Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University College of Medicine) ;
  • Kim, Hyun-Gun (Department of Internal Medicine, Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University College of Medicine) ;
  • Lee, Tae-Hee (Department of Internal Medicine, Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University College of Medicine) ;
  • Kim, Wan-Jung (Department of Internal Medicine, Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University College of Medicine) ;
  • Jun, Sung-Gon (Department of Internal Medicine, Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University College of Medicine) ;
  • Cheon, Gang-Il (Department of Internal Medicine, Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University College of Medicine) ;
  • Lee, Joon-Seong (Department of Internal Medicine, Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University College of Medicine)
  • 강은정 (순천향대학교 의과대학 내과학교실, 소화기 연구소) ;
  • 김진오 (순천향대학교 의과대학 내과학교실, 소화기 연구소) ;
  • 김현건 (순천향대학교 의과대학 내과학교실, 소화기 연구소) ;
  • 이태희 (순천향대학교 의과대학 내과학교실, 소화기 연구소) ;
  • 김완중 (순천향대학교 의과대학 내과학교실, 소화기 연구소) ;
  • 전성곤 (순천향대학교 의과대학 내과학교실, 소화기 연구소) ;
  • 천강일 (순천향대학교 의과대학 내과학교실, 소화기 연구소) ;
  • 이준성 (순천향대학교 의과대학 내과학교실, 소화기 연구소)
  • Published : 2011.02.27
⟨ Previous Next ⟩

Abstract

Pneumatosis cystoides intestinalis (PCI) is an uncommon condition in which submucosal or subserosal gas cysts are present within the bowel wall. We report a case of a 37-year-old man with no medical history. He underwent a colonoscopy for screening purposes, which revealed multiple and variably sized submucosal tumors in the ascending colon. Endoscopic ultrasonographic (EUS) finding showed multiple hyperechogenic regions with distal acoustic shadowing within the submucosa of the ascending colon. A computed tomography scan showed multiple air-filled cystic masses in the ascending colon. EUS appears to be effective for the diagnosis of PCI.

낭성 장기종은 장벽 내에서 발견되는 점막하층 또는 장막하층의 공기주머니로서 흔하지 않은 질환 중 하나이다. 37세 건강한 남성이 건강 검진으로 시행 받은 대장내시경에서 낭성 장기종이 의심되어 내시경 초음파를 시행 받은 경우를 보고한다. 대장내시경에서 상행결장에 다양한 크기의 점막하종양처럼 보이는 병변들이 발견되었고, 내시경 초음파에서 점막하층에 고에코성으로 후방 음영증강을 동반한 병변으로 관찰되었다. 대장내시경과 내시경 초음파 소견을 종합하여 낭성 장기종을 진단할 수 있었다.

Keywords

References

  1. Tsujimoto T, Shioyama E, Moriya K, et al. Pneumatosis cystoides intestinalis following alpha-glucosidase inhibitor treatment: a case report and review of the literature. World J Gastroenterol 2008;14:6087-6092. https://doi.org/10.3748/wjg.14.6087
  2. Nosho K, Hatakeyama K, Hamamoto Y, et al. A case of pneumatosis cystoides intestinalis with dermatomyositis in which EUS was useful for the diagnosis. Int J Colorectal Dis 2005;20:473-474. https://doi.org/10.1007/s00384-004-0680-7
  3. Reynold HL Jr, Gauderer MW, Hrabovsky EE, Shurin SB. Pneumatosis cystoides intestinalis in children beyond the first year of life: manifestations and management. J Pediatr Surg 1991;26:1376-1380.
  4. Matsumoto A, Isomoto H, Shikuwa S, et al. Pneumatosis intestinalis in ulcerative colitis. Med Sci Monit 2009;15:CS139-CS142.
  5. Pickhardt PJ, Kim DH, Taylor AJ. Asymptomatic pneumatosis at CT colonography: a benign self-limited imaging finding distinct from perforation. AJR Am J Roentgenol 2008;190:W112-W117. https://doi.org/10.2214/AJR.07.2843
  6. Jamart J. Pneumatosis cystoides intestinalis: a statistical study of 919 cases. Acta Hepato-Gastroenterol (Stuttg) 1979;26:419-422.
  7. Conner R, Jones B, Fishman EK, Siegelman SS. Pneumatosis intestinalis: role of computed tomography in diagnosis and management. J Comput Assist Tomogr 1984;8:269-275. https://doi.org/10.1016/0149-936X(84)90075-4
  8. Kelvin FM, Korobkin M, Rauch RF, Rice RP, Silverman PM. Computed tomography of pneumatosis intestinalis. J Compt Assist Tomogr 1984;8:276-280. https://doi.org/10.1097/00004728-198404000-00002
  9. Takada C, Kaneko H, Tomomasa T, et al. Endosonographic diagnosis of pneumatosis cystoides intestinalis in infancy. Tech Coloproctol 2002;6:121-123. https://doi.org/10.1007/s101510200026
  10. Bansal R, Bude R, Nostrant TT, Scheiman JM. Diagnosis of colonic pneumatosis cystoides intestinalis by endosonography. Gastrointest Endosc 1995;42:90-93. https://doi.org/10.1016/S0016-5107(95)70254-7
  11. Napoleon B, Pujol B, Valette PJ, Berger F, Souquel JC, Lambert R. Contribution of endosonography in the diagnosis of colorectal submucosal lesions. Gastrointest Endosc 1991;37:263.
  12. Lee J, Park CM, Kim KA, et al. Cystic lesions of the gastrointestinal tract: multimodality imaging with pathologic correlations. Korean J Radiol 2101;11:457-468. https://doi.org/10.3348/kjr.2010.11.4.457