Table of Contents
Definition / general | Terminology | Sites | Etiology | Clinical features | Radiology description | Case reports | Treatment | Clinical images | Gross description | Gross images | Microscopic (histologic) description | Microscopic (histologic) images | Videos | Differential diagnosis | Additional referencesCite this page: Gonzalez R. Pneumatosis cystoides intestinalis. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/colonpneumatosis.html. Accessed February 21st, 2019.
Definition / general
- Submucosal gas filled cysts within gastrointestinal tract
Terminology
- Called mucosal pseudolipomatosis if it resembles lipomatosis microscopically (Am J Clin Pathol 1985;84:575)
Sites
- Entire gastrointestinal tract can be affected
Etiology
- In infants, fulminant form is associated with necrotizing enterocolitis and may be fatal
- Also associated with cystic fibrosis or congenital heart defects
- In adults, either idiopathic or associated with obstruction, chronic lung disease, scleroderma, chemotherapy, drugs, ischemic colitis, vascular insufficiency or infection with gas producing bacteria, such as Clostridia (Am J Med Sci 2006;332:100)
Clinical features
- Either benign or fulminant form
- Often indolent clinical course, although radiographically can resemble carcinoma
- Patients may have nausea, vomiting, diarrhea
- Considered a finding, not a diagnosis
Radiology description
- Multiple, thin walled, air filled submucosal or subserosal cysts
- Air may be present in peritoneum
Case reports
- 6 year old girl with ulcerative colitis (Arch Pathol Lab Med 1999;123:354)
- 25 year old woman with abdominal pain for 10 years and pneumoperitoneum (N Engl J Med 2009;361:e12)
Treatment
- Surgery if bowel necrosis, perforation or peritonitis
Gross description
- Polypoid grape-like masses protruding through mucosa
Gross images
Microscopic (histologic) description
- Empty submucosal cysts lined by multinucleated giant cells
- Mucosa may demonstrate cryptitis, crypt abscesses, granulomas
- Can also resemble lipomatosis
Microscopic (histologic) images
Videos
Pneumatosis intestinalis
Differential diagnosis
Additional references