Pneumatosis cystoides intestinalis: Confirmation of diagnosis by endoscopic puncture a review of pathogenesis, associated disease and therapy and a new theory of cyst formation

Pneumatosis cystoides intestinalis (PCI) is the term for the formation of i ntramural gas filled cysts of unclear pathogenesis in the wall of the gastr ointestinal tract. We report two patients with PCI where the diagnosis was confirmed by endoscopic puncture of a lesion, resulting in a complete defla tion of the cyst, and two patients who underwent surgery. Endoscopy offers a safe and quick way to confirm the diagnosis of PCI. The immunohistochemic al study revealed histiocytic cells and foreign body giant cells in the cys tic wall, corresponding to a secondary histiocytic organization of gas-fill ed pseudocysts rather than to the widespread theory of gas-filled lymph ves sels.