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Minerva Gastroenterologica e Dietologica 2006 September;52(3):339-46


language: English, Italian

Pneumatosis coli induced by acarbose administration for diabetes mellitus. Case report and literature review

Furio L. 1, Vergura M. 2, Russo A. 2, Bisceglia N. 3, Talarico S. 2, Gatta R. 2, Tomaiuolo M. 2, Tomaiuolo P. 2

1 Unit of Gastroenterology and Digestive Endoscopy S. Camillo De Lellis Hospital Manfredonia, Foggia, Italy 2 Unit of Medicine S. Camillo De Lellis Hospital Manfredonia, Foggia, Italy 3 Radiology Unit S. Camillo De Lellis Hospital Manfredonia, Foggia, Italy


The authors report a case report of rare disease interesting the digestive tract and often associated to the other gastrointestinal pathologies and/or pulmonary diseases and can be also associated to not gastrointestinal conditions such as collagen-vascular disease, transplantation, AIDS, use of corticosteroid and chemotherapy; other causes can be iatrogenic such as traumatic gastrointestinal endoscopy (a mucoses biopsy, a polipectomy) or the assumption of lattulosio; in 15-20% of cases the pneumatosis cystoides intestinalis is considered primitive. In the our case the Pneumatosis coli was associated to administration of acarbose; in international literature only four papers in the English language were reported. Our patient showed a strongly aspecific symptomatology and easily attributable in first line or to the pathology of base (diabetic patient) or to the assumption of the acarbose; from about 7-8 months she showed unexplained episodes of crampy abdominal pain, diarrhea with 3-4 defecations/die with semiliquid and normochromic stools, tenesmus and a not better specified loss of weigth. The diagnosis was been perfomed by colonoscopy and confirmed by abdominal CT scan with water enema and histologically; we have used the traditional radiology only to exclude the involvement of other gastroenteric districts. The patient was been treated with O2-therapy associated to antibiotics treatment; the suspension of the causal factor, the acarbose, has been of not secondary importance; the complete resolution of disease was obtained after 15 days of therapy.

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