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May 2, 1977

Pneumoperitoneum Due to Pneumatosis Cystoides Intestinalis in Idiopathic Megacolon

Author Affiliations

From the University of Vermont College of Medicine, Burlington, Vt. Dr Broecker is now with the Medical College of Virginia, Richmond, and Dr Moore is with the Department of Surgery, University of Colorado Medical Center, Swedish Medical Center, and Porter Memorial Hospital, Denver.

JAMA. 1977;237(18):1963. doi:10.1001/jama.1977.03270450053021

PNEUMATOSIS cystoides intestinalis (PCI) is an entity characterized by numerous submucosal or subserosal collections of air-filled cysts in the intestinal tract. This disorder has been described in association with a variety of gastrointestinal (GI) diseases: pyloric stenosis, esophageal stricture, diaphragmatic hernia, inflammatory and obstructive bowel disease, tuberculous enteritis, intestinal neoplasia, For editorial comment see p 1965. and scleroderma, as well as obstructive pulmonary diseases and coughing.1 More recently PCI has been noted following blunt abdominal trauma2 and jejunoileal bypass.3 Herein we report a patient with PCI in association with acquired megacolon.4 To our knowledge, this association has not been previously described.

Report of a Case  A 57-year-old resident of the state mental institution was first admitted to our hospital in November 1974 with abdominal distention, a 7-kg weight loss, and occasional clay-colored stools. A duodenal biopsy specimen revealed chronic inflammation in the lamina propria with no