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Case Reports in Gastrointestinal Medicine
Volume 2018, Article ID 6931747, 4 pages
Case Report

Pneumatosis Coli Formation via Counterperfusion Supersaturation in a Patient with Severe Diarrhea

Rhode Island Hospital and Brown University, USA

Correspondence should be addressed to Eric Vecchio; moc.liamg@oihccev.cire

Received 27 April 2018; Revised 12 July 2018; Accepted 19 July 2018; Published 5 August 2018

Academic Editor: Naohiko Koide

Copyright © 2018 Eric Vecchio et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


We present the case of an elderly male patient with known multiple myeloma who was hospitalized with profuse watery diarrhea and abdominal pain after a course of induction chemotherapy. Intestinal intramural gas was found on imaging and the diagnosis of pneumatosis intestinalis was confirmed by colonoscopy. We propose counterperfusion supersaturation as the etiology for this patient’s pneumatosis coli via disruption of homeostasis between nitrogen and hydrogen normally present in the bowel. His condition was successfully treated with antidiarrheal medications and inhaled oxygen as well as intravenous hydration, and he eventually completed multiple myeloma directed chemotherapy with an excellent response. In this report, we discuss how clinicians can improve management of pneumatosis intestinalis by understanding the proposed pathophysiology.