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J Med Case Rep. 2017 Sep 17;11(1):263. doi: 10.1186/s13256-017-1421-1.

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

Author information

1
Department of Surgery, Yokosuka General Hospital Uwamachi, 2-36 Uwamachi, Yokosuka, Kanagawa, 238-8567, Japan.
2
Department of Surgery, Yokosuka General Hospital Uwamachi, 2-36 Uwamachi, Yokosuka, Kanagawa, 238-8567, Japan. tkato@jichi.ac.jp.
3
Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503, Japan. tkato@jichi.ac.jp.

Abstract

BACKGROUND:

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.

KEYWORDS:

Case report; Granulomatosis with polyangiitis; Hyperbaric oxygen therapy; Intestinal perforation; Pneumatosis cystoides intestinalis

PMID:
28917259
PMCID:
PMC5602788
DOI:
10.1186/s13256-017-1421-1
[Indexed for MEDLINE]
Free PMC Article

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