Pneumatosis cystoides intestinalis associated with alpha-glucosidase inhibitors: a case report and clinical analysis

Objective To report a case of Pneumatosis cystoides intestinalis associated with alpha-glucosidase inhibitors and to explore the etiology, incidence, symptoms, diagnosis and treatment of PCI. Methods A male patient aged 43 was admitted to our hospital due to "repeated diarrhea for 3 years and aggravated for half a year". He has been suffering from type 2 diabetes mellitus for 1 year and treated with acarbose. PCI was confirmed by enhanced CT, EUS, colonoscopy and pathological biopsy of the small intestine.After endoscopic resection of large bulges with a snare and the cessation of acarbose, the intestinal gas cysts disappeared and the patient′s symptoms improved. We collected 16 cases related to aGI treatment in the past 12 years intended to summarize the diagnosis and treatment methods of PCI. Results Among the 16 patients, 2 people were asymptomatic, 1 person with parenteral symptoms, and the rest presented non-specific gastrointestinal symptoms such as abdominal pain, diarrhea, abdominal distension, nausea, blood stool, etc. All patients were diagnosed by abdominal CT, EUS, endoscopic biopsy and cured by conservative treatments. Conclusions Patients with primary disease related to PCI should be aware of the possibility of PCI. Particularly, diabetic patients who under GI treatment should routinely undergo endoscopic and abdominal CT examinations when they have gastrointestinal symptoms such as abdominal pain and diarrhea, and endoscopic treatment could be given when necessary. Key words: Pneumatosis cystoides intestinalis; Alpha glucosidase inhibitors; Snare; Endoscopic treatment