Spontaneous Resolution of Pneumatosis Cystoides Intestinalis Localized in the Sigmoid Colon 6 Months after Hyperbaric Oxygen Therapy

We treated a case that was suggestive of therapy for pneumatosis cystoides intestinalis (PCI) ; here, we report this case after additional observation of this therapy. A 58-year-old woman suffered chiefly from abdominal pain and hematochezia. Multiple cystic lesions and a shallow ulceration located between protrusions were observed by means of barium enema and colonoscopy. Endoscopic ultrasonography showed that gas had accumulated inside of the tumors. No malignancies were observed in the biopsy, and PCI was diagnosed. Hyperbaric oxygen therapy (HOP) was carried out; however, endoscopy immediately following therapy confirmed that the tumors still had not been eliminated. Since the symptoms were not serious, no further action was taken for the time being. When endoscopy was performed 6 months later, it was confirmed that the tumors had disappeared and cicatrized. Imaging revealed characteristic symptoms of PCI. Since it is a relatively rare disease, surgery is seldom performed for PCI. As a rule, HOP is carried out; however, the symptoms are not serious, and spontaneous resolution of the tumors may occur. Therefore, it is possible that, after confirming a diagnosis of PCI, it may be enough to observe the patient's progress, without resorting to HOP.