Top

Published in:

Open Access 01-12-2017 | Case report

Successful treatment with hyperbaric oxygen therapy for pneumatosis cystoides intestinalis as a complication of granulomatosis with polyangiitis: a case report

Published in: Journal of Medical Case Reports | Issue 1/2017

Abstract

Background

Although gastrointestinal involvement in patients with granulomatosis with polyangiitis is uncommon, it is associated with mild to severe life-threatening complications. We present a case of pneumatosis cystoides intestinalis in a patient with granulomatosis with polyangiitis that was treated successfully with hyperbaric oxygen.

Case presentation

A 70-year-old Japanese man with a 3-year history of granulomatosis with polyangiitis consulted our hospital with a complaint of severe back pain. Computed tomography showed a large amount of gas located in his bowel wall and mesentery. He underwent urgent exploratory laparotomy, which led to a diagnosis of pneumatosis cystoides intestinalis without intestinal perforation or necrosis. He consequently underwent 13 sessions of hyperbaric oxygen therapy and was discharged from our hospital without complications.

Conclusions

Several previous reports have supported the efficacy of hyperbaric oxygen for treating pneumatosis cystoides intestinalis. The present case, however, is the first in which pneumatosis cystoides intestinalis in a patient with granulomatosis with polyangiitis was successfully treated with hyperbaric oxygen. We therefore suggest that hyperbaric oxygen therapy could be a candidate treatment for pneumatosis cystoides intestinalis in patients with granulomatosis with polyangiitis.

Masiak A, Zdrojewski L, Zdrojewski Z, Bullo-Piontecka B, Rutkowski B. Gastrointestinal tract involvement in granulomatosis with polyangiitis. Prz Gastroenterol. 2016;11:270–5.PubMedPubMedCentral

Fauci AS, Haynes BF, Katz P, Wolff SM. Wegener’s granulomatosis: prospective clinical and therapeutic experience with 85 patients for 21 years. Ann Intern Med. 1983;98:76–85.CrossRefPubMed

St Peter SD, Abbas MA, Kelly KA. The spectrum of pneumatosis intestinalis. Arch Surg. 2003;138:68–75.CrossRefPubMed

Ivanovic A, Kovac J, Masulovic D, Stefanovic A, Jaksic E, Saranovic D. Education and imaging. Gastrointestinal: the role of multidetector computer tomography in diagnosis of pneumatosis cystoides intestinalis. J Gastroenterol Hepatol. 2012;27:182.CrossRefPubMed

Wu LL, Yang YS, Dou Y, Liu QS. A systematic analysis of pneumatosis cystoids intestinalis. World J Gastroenterol. 2013;19:4973–8.CrossRefPubMedPubMedCentral

Geraghty J, Mackay IR, Smith DC. Intestinal perforation in Wegener’s granulomatosis. Gut. 1986;27:450–1.CrossRefPubMedPubMedCentral

Tokuda M, Kurata N, Daikuhara H, Akisawa M, Onishi I, Asano T, Kobayashi S, Ohmori M, Irino S. Small intestinal perforation in Wegener’s granulomatosis. J Rheumatol. 1989;16:547–9.PubMed

Skaife P, Lee S, Ramadwar M, Maitra D, Edwardson KF. Intestinal perforation as a presentation of Wegener’s granulomatosis. Hosp Med. 2000;61:286–7.CrossRefPubMed

Deniz K, Ozseker HS, Balas S, Akpynar E, Sokmensuer C. Intestinal involvement in Wegener’s granulomatosis. J Gastrointestin Liver Dis. 2007;16:329–31.PubMed

10.

Samim M, Pronk A, Verheijen PM. Intestinal perforation as an early complication in Wegener’s granulomatosis. World J Gastrointest Surg. 2010;2:169–71.CrossRefPubMedPubMedCentral

11.

Gagliardi G, Thompson IW, Hershman MJ, Forbes A, Hawley PR, Talbot IC. Pneumatosis coli: a proposed pathogenesis based on study of 25 cases and review of the literature. Int J Colorectal Dis. 1996;11:111–8.CrossRefPubMed

12.

Ngu J, Lieske B, Chan KH, Lim TZ, Cheong WK, Tan KK. Caecal pneumatosis is not an absolute contraindication for endoluminal stenting in patients with acute malignant large bowel obstruction. ANZ J Surg. 2014;84:772–5.CrossRefPubMed

13.

Forgacs P, Wright PH, Wyatt AP. Treatment of intestinal gas cysts by oxygen breathing. Lancet. 1973;1:579–82.PubMed

14.

Feuerstein JD, White N, Berzin TM. Pneumatosis intestinalis with a focus on hyperbaric oxygen therapy. Mayo Clin Proc. 2014;89:697–703.CrossRefPubMed

Title: Successful treatment with hyperbaric oxygen therapy for pneumatosis cystoides intestinalis as a complication of granulomatosis with polyangiitis: a case report
Publication date: 01-12-2017
Published in: Journal of Medical Case Reports / Issue 1/2017
Electronic ISSN: 1752-1947
DOI: https://doi.org/10.1186/s13256-017-1421-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Successful treatment with hyperbaric oxygen therapy for pneumatosis cystoides intestinalis as a complication of granulomatosis with polyangiitis: a case report

Abstract

Background

Case presentation

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Case presentation

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2017

Visually augmented targeted combination light therapy for acne vulgaris: a case report

Cardiac magnetic resonance imaging-indeterminate/negative cardiac sarcoidosis revealed by 18F-fluorodeoxyglucose-positron emission tomography: two case reports and a review of the literature

Beyond classic dermoscopic patterns of dermatofibromas: a prospective research study

Pneumatosis cystoides intestinalis presenting as pneumoperitoneum in a patient with chronic obstructive pulmonary disease: a case report

A rare presentation of myxofibrosarcoma as a Pancoast tumor: a case report

Deep cerebral venous thrombosis mimicking influenza-associated acute necrotizing encephalopathy: a case report