PNEUMATOSIS COLI WITH OXYGEN BREATHING THERAPY

A 60-year-old woman was admitted to our hospital in December 1987 with a 3-month history of diarrhea and rectal discharge of mucus, which was often blood-streaked. Pneumatosis coli was diagnosed by plain X-ray films of the abdomen, barium enema and colonoscopy. The polypoid lesions were noted in the only sigmoid colon. Oxygen breathing therapy was started for this patient. An oxygen flow of 5 liters per minute was maintained via a face mask, producing a PaO2 of 200 to 300mmHg. Treatment was continued for 2 weeks and the size and response of the cysts to the treatment were assessed by plain X-ray of the abdomen. Repeated barium enema and colonoscopy after the treatment revealed a complete disappearance of gas cysts, and no reccurrence was observed in any colonic region as of 5 months after the treatment. Pneumatosis coli is an uncommon condition in which the wall of the colon contains multiple gas-filled cysts. Its etiology is uncertain, but the disease usually runs a benign course, and so can be treated safely with oxygen breathing alone. Sometimes recurrences have been seen, but it have been resolved through further oxygen breathing. The advantages of oxygen breathing therapy include that it is a simple effective non-surgical approach, but it needs to follow up through examination of the colon after treatment to rule out coexistent pathologic condition.