Open AccessPneumatosis cystoides intestinalis associated with toxic epidermal necrolysis: A case report
Author(s) -
Siyuan Yao,
Ryutaro Seo,
Tohru Nagano,
Kaoru Yamazaki
Publication year - 2014
Publication title -
world journal of clinical cases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.368
H-Index - 10
ISSN - 2307-8960
DOI - 10.12998/wjcc.v2.i9.469
Subject(s) - medicine , pneumatosis cystoides intestinalis , conventional pci , septic shock , pneumatosis intestinalis , toxic epidermal necrolysis , abdominal pain , rare disease , angioedema , surgery , radiology , gastroenterology , dermatology , sepsis , disease , myocardial infarction
Toxic epidermal necrolysis (TEN) is a severe adverse drug reaction, which is characterized by erythema, blisters, and/or erosions of the mucous membranes and skin, but intestinal involvement is rare. In contrast, pneumatosis cystoides intestinalis (PCI) is a rare condition associated with a wide variety of underlying diseases, but to date no patient has presented with PCI associated with TEN. A 55-year-old man was admitted to intensive care unit for treatment of TEN caused by phenobarbital. On day 8 after admission, he presented with progressive abdominal distention and hypotension. Computed tomography (CT) showed gas in the superior mesenteric vein and air filled cysts in the walls of the small intestine. He was suspected of having septic shock due to PCI. As there were no indications of bowel ischemia or necrosis, the patient was managed conservatively with antibiotics and oxygen therapy. On day 10 after admission, he was weaned off catecholamines, with CT on day 11 showing complete resolution of gas in the superior mesenteric vein and air filled cysts. To our knowledge, this article describes the first patient presenting with PCI associated with TEN.