手術後に高圧酸素療法を施行した腸管嚢腫様気腫症の１例

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  • A Case of Pneumatosis Cystoides Intestinalis in which Hyperbaric Oxygen Therapy was Conducted after Surgery.

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A 76-year-old woman was seen at the hospital because of aggravating abdominal pain which was let alone for 2 weeks. There were previous histories of undergoing multiple operations. On admission, there were tenderness and muscle guarding in the epigastrium and left lower quadrant of abdomen. Abdominal plain X-ray film showed linear gas image in the mesenterium, but no subdiaphragmatic free air and Chilaiditi signs were noted. An abdominal CT scan, however, visualized intraabdominal free air, and mesenteric and retroperitoneal emphysema. An emergency operation was performed with a diagnosis of gastrointestinal perforation. Upon laparotomy, intraabdominal free air, wall thickening and adhesions covering the entire small intestine, and mesenteric emphysema were confirmed, but no gastrointestinal perforation and abscess formation were found. From these findings, pneumatosis cystoids intestinalis was diagnosed. After the operation, hyperbaric oxygen therapy was attemtped for the purpose of gaining early recovery, and emphysema disappeared on the 3rd day after the therapy. The patient was discharged from the hospital on 22nd hospital day. There have been no signs of recurrence, as of 9 months after the operation.

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