PNEUMATOSIS-CYSTOIDES-INTESTINALIS

History and clinical findings: A 56-year-old man was admitted to hospi tal for investigation of meteorism and severe flatulence for 10 months and irregular stools. He had no previous illness. On examination his abdomen was quite distended, with very active but low-pitched peristal sis. Investigation: Plain x-ray of the abdomen showed multiple round t ranslucencies along the wall of the left hemicolon. Coloscopy revealed multiple firm-walled cysts in the descending and sigmoid colon which contained H-2 in high concentration. Histologically there was slight i nflammatory infiltration of the submucosa as well as some slit-like ho llow spaces, pointing to the diagnosis of pneumatosis cystoides intest inalis. The H-2 breath test, done to confirm the diagnosis, indicated increased H-2-concentration, both on fasting and after lactulose. Trea tment and course: A diet low in flatulence-producing carbohydates sati sfactorily controlled the symptoms, but the local findings remained un changed over 4 years. Conclusion: Pneumatosis cystoides intestinalis s hould be included in the differential diagnosis of meteorism and flatu lence. Diet can satisfactorily control the symptoms of this rare disea se.