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February 19, 1973

Confusion and Pneumatosis Cystoides Intestinalis With Strangulated Hernia

Author Affiliations

Donald N. Sharp Memorial Community Hospital San Diego, Calif

JAMA. 1973;223(8):920-921. doi:10.1001/jama.1973.03220080050017

To the Editor.—  Pneumatosis cystoides intestinalis is an unusual condition in which gas-containing cysts are found in the intestinal wall. It frequently produces no manifestations, but can rarely cause benign pneumoperitoneum, creating diagnostic confusion with an intra-abdominal catastrophe.

Report of a Case.—  An 89-year-old woman was seen following the onset of mild abdominal distress and significant abdominal distention. She had a long history of chronic congestive heart failure due to arteriosclerotic heart disease, and had cholecystectomy one year earlier for gangrenous cholecystitis. Her condition had been stable until the onset of these symptoms.Physical examination revealed an obese, elderly woman in no apparent distress. There were a few rales at the pulmonary bases posteriorly and the heart was massively enlarged with a systolic apical murmur. The abdomen was greatly distended and tympanitic, but the musculature was soft and normal bowel sounds were present. A tense, very tender, cystic mass protruded