Pneumatosis cystoides intestinalis induced by acarbose treatment

Abstract

Pneumatosis cystoides intestinalis is a rare disorder with multiple submucosal or subserosal gas-filled cysts alongside the
gastrointestinal wall.
Pneumatosis intestinalis can be classified as either primary
(idiopathic) or secondary. Pneumatosis cystoides intestinalis has
been described in association with chronic obstructive pulmonary disease, intestinal obstruction, collagen vascular diseases,
systemic amyloidosis, infectious colitis, intestinal ischemia and
infarction, Crohn’s disease and iatrogenic conditions (drugs, surgery and endoscopy).
Most commonly reported presentations include abdominal pain, subacute intestinal obstruction, diarrhea and bloody stools.
Nevertheless, it is usually asymptomatic and found incidentally during investigation of unrelated symptoms.
Nonoperative management should be pursued in most patients, consisting in oxygen therapy, namely hyperbaric oxygen
therapy. Surgery should be considered for patients who develop complications such as bowel obstruction, perforation, peritonitis and severe hemorrhage.
The authors report a case of pneumatosis intestinalis associated with diabetes pharmacological treatment with acarbose.