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.
Conclusion:
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.
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