Bowel obstruction caused by repeated upper GI endoscopy-induced pneumatosis cystoides intestinalis

摘要

To the Editor: A 58-year-old man was admitted to the outpatient clinic with postprandial vomiting, abdominal discomfort, and weight loss. He had been diagnosed with pyloric stenosis secondary to benign peptic ulcer, and serial diagnostic and therapeutic endoscopies had been performed at other medical centers within the previous 6 months. The patient had been using proton pump inhibitor since then. His other medical histoiy was unremarkable. On admission, physical examination revealed abdominal distention and epigastric tenderness at palpation. Laboratory test findings were normal other than mild leukocytosis (11,200/mm~3) and hypokalemia (3.1 mg/dL). An abdominal radiograph showed dilated small-bowel segments. At CT, there was air below the right diaphragm (Fig. 1), a dilated stomach, and wall thickening and air bubbles at the small bowel (Fig. 2).