Case Report
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Feb 27, 2016; 8(2): 173-178
Published online Feb 27, 2016. doi: 10.4240/wjgs.v8.i2.173
Pneumatosis intestinalis with obstructing intussusception: A case report and literature review
Yujiro Itazaki, Hironori Tsujimoto, Nozomi Ito, Hiroyuki Horiguchi, Shinsuke Nomura, Kyohei Kanematsu, Shuichi Hiraki, Suefumi Aosasa, Junji Yamamoto, Kazuo Hase
Yujiro Itazaki, Hironori Tsujimoto, Nozomi Ito, Hiroyuki Horiguchi, Shinsuke Nomura, Kyohei Kanematsu, Shuichi Hiraki, Suefumi Aosasa, Junji Yamamoto, Kazuo Hase, Department of Surgery, National Defense Medical College, Saitama 359-8513, Japan
Author contributions: Itazaki Y, Tsujimoto H and Hiraki S designed the research; Ito N, Horiguchi H, Nomura S, Kanematsu K and Aosasa S performed the research; Itazaki Y, Tsujimoto H, Yamamoto J and Hase K wrote the paper; all authors had substantial contributions to conception, design, and reviewing the manuscript; all authors have approved the manuscript and agree with submission to the journal.
Supported by JSPS KAKENHI, No. 15K10042.
Institutional review board statement: This study had reviewed by National Defense Medical College.
Informed consent statement: Written informed consent was obtained from the patient.
Conflict-of-interest statement: All authors certify that they have no commercial associations that might pose a conflict of interest in connection with submitted article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Hironori Tsujimoto, MD, PhD, Department of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan. tsujihi@ndmc.ac.jp
Telephone: +81-4-29951637 Fax: +81-4-29965205
Received: May 20, 2015
Peer-review started: May 21, 2015
First decision: August 4, 2015
Revised: September 16, 2015
Accepted: October 16, 2015
Article in press: October 17, 2015
Published online: February 27, 2016
Processing time: 283 Days and 12.4 Hours
Abstract

Pneumatosis intestinalis (PI) often represents a benign condition that should not be considered as an argument for surgery. We report a patient with PI and obstructing intussusception who underwent urgent colectomy and review the literatures regarding PI with intussusception. A 20-year-old man presented at our hospital with a 3-d intermittent lower abdominal pain history. He underwent steroid therapy for membranoproliferative glomerulonephritis for 4 years. Computed tomography revealed ascending colon intussusception with air within the wall. Intraoperative colonoscopy revealed numerous soft polypoid masses with normal overlying mucosa and right hemicolectomy was performed. Histological examination of colonic wall sections revealed large cysts in the submucosal layer. The pathological diagnosis was PI. Nine cases of intussusception associated with primary PI have been reported. Although primary PI often represents a benign condition that should not be considered as an argument for surgery, if the case involves intussusception and obstruction, emergent laparotomy should be considered.

Keywords: Pneumatosis intestinalis; Intussusception; Urgent surgery; Immunosuppressive drug; Ischemia of the intestine

Core tip: We report a patient with pneumatosis intestinalis (PI) and obstructing intussusception who underwent urgent colectomy and review the literatures regarding PI with intussusception. A 20-year-old man presented at our hospital with abdominal pain, and has undergone steroid therapy for 4 years. Computed tomography revealed ascending colon intussusception with air within the wall, and colectomy was performed. Histological examination of colonic wall sections revealed large cysts in the submucosal layer. Nine cases of intussusception associated with primary PI have been reported. Although primary PI often represents a benign condition, if the case involves intussusception and obstruction, emergent laparotomy should be considered.