Peritonitis by Ulcer Perforation Revealing Intestinal Cystic Pneumatosis: About A Case

Abstract

Intestinal cystic pneumatosis (ICP) is a rare disease, defined by the presence of gaseous cysts in the digestive wall with intestinal predilection. The first case was described in autopsy specimen in 1730 by Duo Vernoi. rare condition characterized by multiple gas-filled cysts in the intestinal wall and can be caused by many conditions. As patients with PCI are mostly asymptomatic, they are not likely to seek medical care. It affected any portion of gastrointestinal tract with the cysts being either confined to the mucosa, submucosa, or subserosa or involving all three layers. It is primary in 15% of cases and complicates an underlying pathology in 85% of cases. We report the case of a 47-year-old chronic smoker who had a history of epigastralgia, admitted to the emergency room for an acute abdominal pain with septic shock. A laparotomy was performed showing necrosis ileum with ICP associated to ulcerative pyloric stenosis & ulcer perforation peritonitis. Therapeutic management consisted of specific treatment of the pathology associated with grelic resection of the necrosis ileum affected by ICP. The patient died during his stay in intensive care on 3th day due to multi-visceral failure despite all intense resuscitation efforts.