12th Ljudevit Jurak International Symposium on
Comparative Pathology
June 1-2, 2001

G. Petruševska, R. Jovanoviæ
Institute of Pathology, Faculty of Medicine, Skopje, R. Macedonia
Pneumatosis cystoides intestinalis is a condition characterized by gass-filled cysts disposed in the submucosa or wall of the intestine. We are reporting a case of a 72- year old woman that had undergone surgical treatment because of the symptoms of ileus. A month before the operation, she was treated surgically for a perforated peptic ulcer. Beside macroscopic description, standard histological technique was performed over 4-6  thick, paraffin embeded sections. In addition immunohistochemical stainings for MAC387, CD68, CD31, FVIII, HLA DR- and collagen IV were done. At the Institute of Pathology a fragment of 110 cm of ileum was delivered. The wall of the intestine was irregularly thickened, showing nodular extrusions on the mucosal and subserosal lining. During dissection gass-filled cysts were found, ranging in diameter from few milimeters to a centimeter or more.  There was  no communication  between the cysts or the intestinal lumen. Histologicaly the cysts were lined by flattened multinucleated giant cells positive for histiocytic markers (CD68, MAC387, HLA DR-).Considering the condition of the perforated peptic ulcer a month before the symptoms of the ileus appeared, one could conclude that the intestinal pneumatosis with the described histologic picture, had occured as a result of the diffusion of  gass from the perforated ulcer, and a defence reaction of the intestinal wall to foreign agents (peptic content, chemical and bacterial agents). 
Poster Presentation