Pneumatosis Cystoides Intestinalis

We herein present a case of pneumatosis cystoides intestinalis. A 56-year-old woman was admitted to Nagasaki Prefectural Shimabara Hospital with diffuse and mild abdominal pain. A plain abdominal X-ray revealed free air in the right subphrenic space, and computed tomography showed an extraluminal gas-filled lesion adjacent to the small intestine. With a tentative diagnosis of perforation of the small intestine, a laparotomy was performed, although she had little tenderness and no rigidity on physical examination. Upon opening the peritoneal cavity, multiple bullae-like cysts were noted on approximately one meter of the ileal serosa; however, no site of perforation was detected. Removal of the portion of what appeared to be the affected bowel was the procedure of choice. The resected specimens histologically showed pneumatosis cystoides intestinalis without any perforation. Her postoperative course was uneventful and she has been doing well with no evidence of recurrence as of the end of June 2005

Duodenocolic Fistula Originating from Ascending Colon Cancer in the Blind Loop

We herein present the case of a 68-year-old male with a duodenocolic fistula originating from ascending colon cancer in the blind loop, which was resected by a right hemicolectomy with pancreaticoduodenectomy. The present case achieved 14 months of disease-free survival after the operation. There have been reported, in the literature in Japanese and English, a total of 26 cases including the present one that have undergone a right hemicolectomy with pancreaticoduodenectomy for right-sided colon cancer with duodenocolic fistulae. The survival periods in these cases ranged from 5 months to 12 years after the operation. Thirteen patients survived for over 1 year. A right hemicolectomy with pancreaticoduodenectomy for locally advanced right-sided colon cancers with duodenal invasion could be expected to yield long-term survival if peritoneal and distant metastases are not present

Pneumatosis Cystoides Intestinalis

We herein present a case of pneumatosis cystoides intestinalis. A 56-year-old woman was admitted to Nagasaki Prefectural Shimabara Hospital with diffuse and mild abdominal pain. A plain abdominal X-ray revealed free air in the right subphrenic space, and computed tomography showed an extraluminal gas-filled lesion adjacent to the small intestine. With a tentative diagnosis of perforation of the small intestine, a laparotomy was performed, although she had little tenderness and no rigidity on physical examination. Upon opening the peritoneal cavity, multiple bullae-like cysts were noted on approximately one meter of the ileal serosa; however, no site of perforation was detected. Removal of the portion of what appeared to be the affected bowel was the procedure of choice. The resected specimens histologically showed pneumatosis cystoides intestinalis without any perforation. Her postoperative course was uneventful and she has been doing well with no evidence of recurrence as of the end of June 2005