A Case of Pneumatosis Cystoides Intestinalis in a Patient with Dermatomyositis

Dong Jin Go; Jeong Seok Lee; Sang Hyun Joo; Jinyoung Moon; Jae Hyun Lee; Eun Young Lee

doi:10.4078/jrd.2015.22.4.238

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Go, Lee, Joo, Moon, Lee, and Lee: A Case of Pneumatosis Cystoides Intestinalis in a Patient with Dermatomyositis

Case Report

J Rheum Dis 2015;22(4):238-241.

Published online: 31 October 2015

DOI: https://doi.org/10.4078/jrd.2015.22.4.238

A Case of Pneumatosis Cystoides Intestinalis in a Patient with Dermatomyositis

Dong Jin Go, Jeong Seok Lee, Sang Hyun Joo, Jinyoung Moon, Jae Hyun Lee, Eun Young Lee

Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea

Corresponding to: Eun Young Lee, Department Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea. E-mail: elee@snu.ac.kr

Received 24 June 2014 Revised 20 August 2014 Accepted 21 August 2014

This is a Free Access article, which permits unrestricted non-commerical use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Pneumatosis cystoides intestinalis, Dermatomyositis, Corticosteroids

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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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