Pneumatosis intestinalis in an adult patient with antral stenosis and midgut malrotation

BMJ Case Reports
Mehrnaz MehrkhuAmir Shirvani Dehkordi

Abstract

Pneumatosisintestinalis (PI) is a radiological finding with about 0.03% incidence and incompletely understood pathogenesis. We report a case of PI with a rare presentation of pneumoperitoneum that underwent diagnostic surgery and finally diagnosed by midgut malrotation and antral stenosis. A 40-year-old man with 1-year history of dyspepsia and vomiting which was aggravated by 20 kg underweight since 3 months ago, despite medications was presented. His imaging examinations showed partial antral obstruction besides pneumoperitoneum and gas collection in the small intestine wall, which were in favour of PI. Samplings of the small intestine during laparotomy reported simple serosal cysts. Persistence of his symptoms forced him to recourse to another hospital and their new imaging revealed Ladds' band in addition to mentioned findings in previous studies; he underwent subtotal gastrectomy plus Ladds' band division by Braun gastrojejunostomy. PI could be a presentation of antral stenosis and midgut malrotation. PI with pneumoperitoneum needs surgical interventions. Considering that most of the midgut malrotation cases are diagnosed in the first year of life and it is very rare in adults, it may bethat these new findings are due to ad...Continue Reading

References

Feb 22, 2012·World Journal of Gastroenterology : WJG·Zulfu ArikanogluCuneyt Kirkil
Mar 14, 2012·The Journal of Emergency Medicine·Jaclyn R Schieber, Scott C Sherman
Aug 16, 2013·World Journal of Gastroenterology : WJG·Li-Li WuQing-Sen Liu
Apr 17, 2016·International Journal of Surgery Case Reports·Filza KhalidYousif ElTayeb
Sep 22, 2016·Case Reports in Gastrointestinal Medicine·Manabu KanekoToshiyuki Watanabe

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Citations

Feb 8, 2020·World Journal of Surgery·Jonathan J NevilleHemant Sheth

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