Year 2020 Vol. 28 No 1

CASE REPORTS

S.V. PETROV 1, V.P. ZEMLIANOI 2, B.V. SIGUA 2, A.V. VOVK 1, D.A. CHERNISHEV 1, P.A. KOTKOV 1, V.A. IGNATENKO 1, R.R. FEVZIEV 1

PNEUMATOSIS CYSTOIDES INTESTINALIS - RARE CAUSE OF NON-SURGICAL PNEUMOPERITONEUM

St. Petersburg State Budgetary Healthcare Institution "Elizabethan Hospital"1,
North-Western State Medical University named after I.I. Mechnikov 2, St. Petersburg,
The Russian Federation

For the first time, intestinal air cysts were described by Du Vernoi in 1783. For more than 230-year history of studying this disease, a large number of clinical examples, reviews and hypotheses have been accumulated in the literature, explaining the pathogenesis of the pneumatosis cystoides intestinalis and treatment methods. The clinical symptoms of this disease are extremely nonspecific, the anamnestic features are also often absent, therefore intestinal emphysema is most often detected as a concomitant state or intraoperatively, if we are talking about a complicated case. The article presents a clinical case of pneumatosis cystoides intestinalis, the only manifestation of which was free gas in the abdominal cavity, which served as an indication for emergency surgery. The scanty clinical symptoms and normal laboratory findings usually tend the surgeon to choose less invasive research methods, but diagnostic laparoscopy in the described case was impossible due to repeated surgical interventions on the abdominal organs, as well as the presence of contraindications from the pulmonary system. The described observation indicates the existence non-surgical causes of pneumoperitoneum, despite its high specificity in the diagnosis of hollow organs perforations.

Keywords: pneumatosis cystoides intestinalis, intestinal emphysema, pneumoperitoneum, pulmonary emphysema, diagnostic laparoscopy
p. 106-111 of the original issue
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Address for correspondence:
191015, Russian Federation,
Saint-Petersburg, Kirochnaya Str., 41,
North-Western State Medical University
named after I.I. Mechnikov,
Faculty Surgery Department named after I.I. Grekov.
Tel. +790626192131,
e-mail: kotkovdr@mail.ru,
Pavel A. Kotkov
Information about the authors:
Petrov Sergey V., MD, Professor, Chief Physician, St. Petersburg State Budgetary Healthcare Institution «Elizabethan Hospital», Saint-Petersburg, Russian Federation.
https://orcid.org/0000-0003-4398-5770
Zemlianoi Viacheslav P., MD, Professor, Head of the Faculty Surgery Department named after I.I. Grekov, North-Western State Medical University named after I.I. Mechnikov, Saint-Petersburg, Russian Federation.
https://orcid.org/0000-0003-2329-0023
Sigua Badri V., MD, Professor of the Faculty Surgery Department named after I.I. Grekov, North-Western State Medical University named after I.I. Mechnikov, Saint-Petersburg, Russian Federation.
https://orcid.org/0000-0002-4556-4913
Vovk Andrei V., PhD, Deputy Chief Physician for Medical Affairs, St. Petersburg State Budgetary Healthcare Institution «Elizabethan Hospital», Saint-Petersburg, Russian Federation.
https://orcid.org/0000-0002-6550-589X
Chernishev Denis A., PhD, Deputy Chief Physician for Surgery, St. Petersburg State Budgetary Healthcare Institution «Elizabethan Hospital», Saint-Petersburg, Russian Federation.
https://orcid.org/0000-0001-9055-7651
Kotkov Pavel A., PhD, Surgeon of the Surgical Unit №2, St. Petersburg State Budgetary Healthcare Institution «Elizabethan Hospital», Saint-Petersburg, Russian Federation.
https://orcid.org/0000-0002-9762-9854
Ignatenko Viktor A., Head of the Surgical Unit №2, St. Petersburg State Budgetary Healthcare Institution «Elizabethan Hospital», Saint-Petersburg, Russian Federation.
https://orcid.org/0000-0002-6615-3005
Fevziev Rishat R., Surgeon of the Surgical Unit №2, St. Petersburg State Budgetary Healthcare Institution «Elizabethan Hospital», Saint-Petersburg, Russian Federation.
https://orcid.org/0000-0003-1722-8485
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