PMC10267610_01
Computed tomography image on admission shows a target sign in the ileocecal region, indicating intussusception (red circle).
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C-reactive protein level of 2.5 mg/dl, but no other abnormal findings were noted. Computed tomography (CT) of the abdomen showed a target sign in the terminal ileum, suggesting intussusception (Figure 1).
Colonoscopy: (a) Multiple smooth, elevated lesions on the mucosal surface in the cecum. (b) Multiple smooth, elevated lesions on the mucosal surface in the ascending colon. (c) Mucosal defects in the pneumatosis cystoides intestinalis. (d) Lesions are soft and show depression when pressed with biopsy forceps.
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These multiple elevated lesions depressed when pressed with biopsy forceps (Figure 2).
Computed tomography image (lung window) immediately after endoscopy showing findings of multiple spherical emphysematous lesions in the wall of the ascending colon (red circle).
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While endoscopic findings suggested lymphoma as a differential diagnosis, the diagnosis of PCI was made based on the CT images showing emphysematous lesions (Figure 3) and the above-described multiple scattered masses on endoscopy. However, the cystic emphysematous lesions scattered throughout the ascending colon, which is suggestive of PCI, clearly remained (Figure 3).
Computed tomography image on day 10 of reconstruction showing the emphysematous lesions had shrunk significantly (red circle).
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Although confirmation endoscopy could not be performed owing to the patient's refusal, follow-up CT on day 10 after recovery showed that the PCI had decreased (Figure 4).