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Pneumatosis Coli: Characteristics, Diagnosis, and Etiologies

An elderly patient presented with abdominal pain, diarrhea, and fever. A colonoscopy found pneumastosis coli in sigmoid colon polypoid lesions ranging from 10 to 30mm in size. This article describes the diagnosis, characteristics, and etiologies of pneumatosis coli.

Key Points:

  • Pneumatosis coli is the presence of multiple gaseous cysts inside the bowel wall.
  • It can present in children and adults with life-threatening and “benign” forms due to various etiologies.
  • In this case, the triggering event had already subsided, and the patient did not require additional endoscopic or medical therapy.
  • Characteristics of pneumatosis coli include soft polypoid lesions that appear as “blebs” and may have areas of erythema.
  • The mucosa overlying the lesion is normal without any specific pit pattern or ulcerations.
  • Etiologies of pneumatosis coli include pulmonary disease, bacterial gas production, dysbiosis, mucosal damage, and ischemia.
  • Histology is usually not needed for diagnosis, and the outcome depends on the primary diagnosis.

Pneumatosis coli is a condition with multiple potential etiologies that can present in children and adults. The diagnosis is based on endoscopic and descriptive appearance, and treatment depends on the primary diagnosis.

Read more here: https://www.thepracticingendoscopist.com/p/multiple-polypoid-sigmoid-colon-lesions

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