Pneumatosis cystoides intestinalis (Duvernoy) syndrome refers to the presence of multiple gas-filled cysts of varying sizes beneath the intestinal mucosa or serosa, resembling polyps in appearance. It is also known as intestinal pneumatosis, pneumatosis cystoides intestinalis, cystic lymphopneumatosis, or pneumoperitoneum.

bubble_chart Etiology

The cause of pneumatosis cystoides is unclear. Intestinal gas enters the intestinal wall through tissue gaps under increased intraluminal pressure, often via ulcers or ruptures. Low-virulence gas-producing bacteria enter the lymphatic vessels through the intestinal mucosa, multiply, and produce gas, leading to cyst formation. The cysts resemble polyps or lymphangiomas in appearance, with a honeycomb-like cross-section. They are surrounded by connective tissue and do not communicate with the intestinal lumen.

bubble_chart Auxiliary Examination

1. The direct signs of X-ray include the double-edge sign along the intestinal wall or a gas band along the long axis of the intestine, as well as scattered localized round gas shadows of an abdominal mass.
2. After barium filling, there may be cystic translucent areas of varying sizes along the intestinal wall or within the lumen. Indirect signs may include pneumoperitoneum, pneumomediastinum, interposed small intestine, or colon.
3. Fiberoptic colonoscopy may reveal round, pale blue polypoid soft tissue masses protruding into the lumen. Biopsy may result in gas expulsion and observed cyst collapse.

bubble_chart Diagnosis

Clinical manifestations, X-ray examination, fiber colonoscopy, and biopsy, along with the observation of gas expulsion and cyst collapse, all contribute to the diagnosis.

Treatment options include hyperbaric oxygen therapy. For severe cases or those with serious complications, surgical removal may be performed, but recurrence is common.