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Successful treatment with hyperbaric oxygen therapy for pneumatosis cystoides intestinalis as a complication of granulomatosis with polyangiitis: a case report.

AbstractBACKGROUND:
Although gastrointestinal involvement in patients with granulomatosis with polyangiitis is uncommon, it is associated with mild to severe life-threatening complications. We present a case of pneumatosis cystoides intestinalis in a patient with granulomatosis with polyangiitis that was treated successfully with hyperbaric oxygen.
CASE PRESENTATION:
A 70-year-old Japanese man with a 3-year history of granulomatosis with polyangiitis consulted our hospital with a complaint of severe back pain. Computed tomography showed a large amount of gas located in his bowel wall and mesentery. He underwent urgent exploratory laparotomy, which led to a diagnosis of pneumatosis cystoides intestinalis without intestinal perforation or necrosis. He consequently underwent 13 sessions of hyperbaric oxygen therapy and was discharged from our hospital without complications.
CONCLUSIONS:
Several previous reports have supported the efficacy of hyperbaric oxygen for treating pneumatosis cystoides intestinalis. The present case, however, is the first in which pneumatosis cystoides intestinalis in a patient with granulomatosis with polyangiitis was successfully treated with hyperbaric oxygen. We therefore suggest that hyperbaric oxygen therapy could be a candidate treatment for pneumatosis cystoides intestinalis in patients with granulomatosis with polyangiitis.
AuthorsKensuke Nakatani, Takaharu Kato, Shinichiro Okada, Risa Matsumoto, Kazuhiro Nishida, Hiroyasu Komuro, Toshiyuki Suganuma
JournalJournal of medical case reports (J Med Case Rep) Vol. 11 Issue 1 Pg. 263 (Sep 17 2017) ISSN: 1752-1947 [Electronic] England
PMID28917259 (Publication Type: Case Reports, Journal Article)
Topics
  • Abdominal Cavity (diagnostic imaging)
  • Aged
  • Granulomatosis with Polyangiitis (complications)
  • Humans
  • Hyperbaric Oxygenation (methods)
  • Male
  • Pneumatosis Cystoides Intestinalis (complications, diagnosis, therapy)
  • Tomography, X-Ray Computed
  • Treatment Outcome

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