kian-peng julian ong(singapore) • kheng-hong ng •
kiat-hon lim • su-chong a. Low •
kong-weng european
a 69-12 months-old man offered with intestinal obstruction and peritonism. Chest and stomach x-rays showed big pneumoperitoneum with huge bowel obstruction (figs. 1, 2). Exploratory laparotomy found out closed loop obstruction secondary to sigmoid volvulus with large pneumatosis cystoids intestinalis of non-dilated small bowel (figs. 3, 4), without evidence of perforation. We postulate that rupture of a submucosal cyst within the small bowel resulted in pneumoperitoneum. General colectomy became achieved, with ileocecal anastomosis and defunctioning ileostomy. Histology confirmed pneumatosis cystoides intestinalis of small bowel with out complete-thickness perforation (figs. 5, 6).
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