Image of the month
A rare cause of lower gastrointestinal bleeding: Pneumatosis cystoides intestinalis
Una causa rara de hemorragia digestiva baja: neumatosis cystoides intestinalis
Eduardo Dantas
, Mariana Coelho, Cláudia Cardoso, Ana Paula Oliveira
Corresponding author
Gastroenterology Department, Centro Hospitalar de Setúbal, Setúbal, Portugal
Read
400
Timeswas read the article
145
Total PDF
255
Total HTML
Share statistics
array:24 [ "pii" => "S0210570521000601" "issn" => "02105705" "doi" => "10.1016/j.gastrohep.2021.01.011" "estado" => "S300" "fechaPublicacion" => "2022-08-01" "aid" => "1768" "copyright" => "Elsevier España, S.L.U.. All rights reserved" "copyrightAnyo" => "2021" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Gastroenterol Hepatol. 2022;45:555-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "en" => array:19 [ "pii" => "S2444382422001353" "issn" => "24443824" "doi" => "10.1016/j.gastre.2021.01.007" "estado" => "S300" "fechaPublicacion" => "2022-08-01" "aid" => "1768" "copyright" => "Elsevier España, S.L.U." "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Gastroenterol Hepatol. 2022;45:555-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image of the month</span>" "titulo" => "A rare cause of lower gastrointestinal bleeding: Pneumatosis cystoides intestinalis" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "555" "paginaFinal" => "556" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Una causa rara de hemorragia digestiva baja: neumatosis cystoides intestinalis" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1164 "Ancho" => 2508 "Tamanyo" => 246855 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Colonoscopy with multiple cystic images of varied sizes in the descending colon (A), with erythematous overlying mucosa (B).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Eduardo Dantas, Mariana Coelho, Cláudia Cardoso, Ana Paula Oliveira" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Eduardo" "apellidos" => "Dantas" ] 1 => array:2 [ "nombre" => "Mariana" "apellidos" => "Coelho" ] 2 => array:2 [ "nombre" => "Cláudia" "apellidos" => "Cardoso" ] 3 => array:2 [ "nombre" => "Ana Paula" "apellidos" => "Oliveira" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0210570521000601" "doi" => "10.1016/j.gastrohep.2021.01.011" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210570521000601?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444382422001353?idApp=UINPBA00004N" "url" => "/24443824/0000004500000007/v1_202208200553/S2444382422001353/v1_202208200553/en/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S0210570521001096" "issn" => "02105705" "doi" => "10.1016/j.gastrohep.2021.02.012" "estado" => "S300" "fechaPublicacion" => "2022-08-01" "aid" => "1783" "copyright" => "Elsevier España, S.L.U." "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Gastroenterol Hepatol. 2022;45:557-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Imagen del mes</span>" "titulo" => "Obstrucción intestinal secundaria a hernia intercostal transdiafragmática" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "557" "paginaFinal" => "558" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Bowel obstruction secondary to transdiaphragmatic intercostal hernia" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figura 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 658 "Ancho" => 905 "Tamanyo" => 90129 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Corte transversal a nivel torácico. Cambio de calibre intestinal entre la 9.ª y la 10.ª costilla (flecha).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Lara Blanco Terés, Íñigo García Sanz, Cristina Marín Campos, Álvaro Gancedo Quintana, Elena Martín-Pérez" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Lara" "apellidos" => "Blanco Terés" ] 1 => array:2 [ "nombre" => "Íñigo" "apellidos" => "García Sanz" ] 2 => array:2 [ "nombre" => "Cristina" "apellidos" => "Marín Campos" ] 3 => array:2 [ "nombre" => "Álvaro" "apellidos" => "Gancedo Quintana" ] 4 => array:2 [ "nombre" => "Elena" "apellidos" => "Martín-Pérez" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2444382422001183" "doi" => "10.1016/j.gastre.2021.02.014" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444382422001183?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210570521001096?idApp=UINPBA00004N" "url" => "/02105705/0000004500000007/v1_202207130605/S0210570521001096/v1_202207130605/es/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S0210570522000541" "issn" => "02105705" "doi" => "10.1016/j.gastrohep.2022.01.008" "estado" => "S300" "fechaPublicacion" => "2022-08-01" "aid" => "1916" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Gastroenterol Hepatol. 2022;45:552-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific letter</span>" "titulo" => "HCC-neuroendocrine transition: Tumor plasticity under immunotherapy" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "552" "paginaFinal" => "554" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Transición de CHC a tumor neuroendocrino: plasticidad tumoral bajo inmunoterapia" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1709 "Ancho" => 3175 "Tamanyo" => 1030584 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A–E (20×) Block cell from the baseline FNB showing an HCC in H&E (A), with positivity for hepatocyte markers (B, C) and negativity for synaptophysin (D). F–J (20×) Second liver biopsy showing a neuroendocrine carcinoma in H&E (F), with negativity for hepatocyte markers (G, H) and positivity for synaptophysin (I). (E and J) Ki67, showing a proliferation rate above 80% in the biopsy (J), much higher than in FNB (E).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Marco Sanduzzi-Zamparelli, Carla Fuster-Anglada, Jordi Bruix, Maria Reig, Alba Díaz" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Marco" "apellidos" => "Sanduzzi-Zamparelli" ] 1 => array:2 [ "nombre" => "Carla" "apellidos" => "Fuster-Anglada" ] 2 => array:2 [ "nombre" => "Jordi" "apellidos" => "Bruix" ] 3 => array:2 [ "nombre" => "Maria" "apellidos" => "Reig" ] 4 => array:2 [ "nombre" => "Alba" "apellidos" => "Díaz" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2444382422001419" "doi" => "10.1016/j.gastre.2022.01.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444382422001419?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210570522000541?idApp=UINPBA00004N" "url" => "/02105705/0000004500000007/v1_202207130605/S0210570522000541/v1_202207130605/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image of the month</span>" "titulo" => "A rare cause of lower gastrointestinal bleeding: Pneumatosis cystoides intestinalis" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "555" "paginaFinal" => "556" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Eduardo Dantas, Mariana Coelho, Cláudia Cardoso, Ana Paula Oliveira" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Eduardo" "apellidos" => "Dantas" "email" => array:1 [ 0 => "dantas16@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Mariana" "apellidos" => "Coelho" ] 2 => array:2 [ "nombre" => "Cláudia" "apellidos" => "Cardoso" ] 3 => array:2 [ "nombre" => "Ana Paula" "apellidos" => "Oliveira" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Gastroenterology Department, Centro Hospitalar de Setúbal, Setúbal, Portugal" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Una causa rara de hemorragia digestiva baja: neumatosis cystoides intestinalis" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1298 "Ancho" => 2508 "Tamanyo" => 261573 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Abdominal CT images showing air-filled cysts within the bowel wall (arrows) of the descending colon.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 70-year-old man presented to the emergency department with 1-week history of rectal bleeding. Physical examination was unremarkable. Laboratory tests revealed no abnormalities. Colonoscopy revealed multiple submucosal cysts of varied sizes in the descending colon, some with markedly erythematous overlying mucosa (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>); one of the cysts was biopsied, with release of gas and subsequent cyst deflation. Abdominal computerized tomography (CT) confirmed the presence of multiple grape-like air collections within the bowel wall of the descending colon (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>), confirming the diagnosis of pneumatosis cystoides intestinalis (PCI). The patient was managed conservatively and discharged 2 days later, without further gastrointestinal (GI) bleeding. Unfortunately, he was lost to follow-up.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">PCI is a rare disease characterized by accumulation of cysts filled with gas in the intestinal wall. Clinical manifestations are nonspecific, including abdominal pain, bloating, diarrhea or lower GI bleeding. Endoscopically is characterized by multiple protuberant lesions covered by normal or erythematous mucosa; as such findings are suspicious but not diagnostic, usually abdominal CT is required for confirmation, showing gas-filled clusters in the bowel wall.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a> There is no consensus regarding treatment; however, conservative management is successful in most cases.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">2</span></a></p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1164 "Ancho" => 2508 "Tamanyo" => 246855 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Colonoscopy with multiple cystic images of varied sizes in the descending colon (A), with erythematous overlying mucosa (B).</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1298 "Ancho" => 2508 "Tamanyo" => 261573 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Abdominal CT images showing air-filled cysts within the bowel wall (arrows) of the descending colon.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0015" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pneumatosis cystoides, CT colonoscopy and endoscopic correlation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "D. Rodríguez-Sánchez" 1 => "M.E. Sáez-Martínez" 2 => "R.M. Sánchez-Jiménez" 3 => "J. d-Dios-Berná-Mestre" 4 => "F. Guzmán-Aroca" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4321/S1130-01082013000800007" "Revista" => array:6 [ "tituloSerie" => "Rev Esp Enferm Dig" "fecha" => "2013" "volumen" => "105" "paginaInicial" => "486" "paginaFinal" => "487" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24274446" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pneumatosis cystoides intestinalis: a case report and literature review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "F. Ling" 1 => "D. Guo" 2 => "L. Zhu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s12876-019-1087-9" "Revista" => array:5 [ "tituloSerie" => "BMC Gastroenterol" "fecha" => "2019" "volumen" => "19" "paginaInicial" => "176" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31694581" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/02105705/0000004500000007/v1_202207130605/S0210570521000601/v1_202207130605/en/main.assets" "Apartado" => array:4 [ "identificador" => "93594" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Imágenes del mes" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/02105705/0000004500000007/v1_202207130605/S0210570521000601/v1_202207130605/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210570521000601?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 2 | 0 | 2 |
| 2024 October | 11 | 7 | 18 |
| 2024 September | 9 | 4 | 13 |
| 2024 August | 19 | 14 | 33 |
| 2024 June | 8 | 7 | 15 |
| 2024 May | 8 | 7 | 15 |
| 2024 April | 8 | 9 | 17 |
| 2024 March | 10 | 12 | 22 |
| 2024 February | 9 | 3 | 12 |
| 2024 January | 7 | 0 | 7 |
| 2023 December | 10 | 0 | 10 |
| 2023 November | 9 | 0 | 9 |
| 2023 October | 20 | 0 | 20 |
| 2023 September | 10 | 0 | 10 |
| 2023 August | 14 | 0 | 14 |
| 2023 July | 13 | 0 | 13 |
| 2023 June | 13 | 2 | 15 |
| 2023 May | 2 | 0 | 2 |
| 2023 April | 5 | 1 | 6 |
| 2023 March | 7 | 7 | 14 |
| 2023 February | 5 | 5 | 10 |
| 2023 January | 9 | 7 | 16 |
| 2022 December | 6 | 9 | 15 |
| 2022 November | 6 | 5 | 11 |
| 2022 October | 6 | 8 | 14 |
| 2022 September | 9 | 4 | 13 |
| 2022 August | 12 | 14 | 26 |
| 2022 July | 8 | 7 | 15 |
| 2022 May | 0 | 1 | 1 |
| 2022 March | 0 | 1 | 1 |
| 2022 February | 0 | 1 | 1 |
| 2021 December | 0 | 1 | 1 |
| 2021 November | 0 | 1 | 1 |
| 2021 July | 0 | 1 | 1 |
| 2021 May | 0 | 2 | 2 |
| 2021 March | 0 | 3 | 3 |
| 2021 February | 0 | 2 | 2 |
Show all
