Bronchoperitoneal fistula in a patient with pneumatosis Cystoides intestinalis: a diagnostic challenge.

BACKGROUND

Pneumatosis cystoides intestinalis (PCI) is a rare condition characterized by the presence of multiple gas-filled cysts within the wall of the gastrointestinal tract, leading to variable clinical presentations and diagnostic challenges. A bronchoperitoneal fistula is an exceedingly rare complication, typically resulting from downward gas tracking secondary to thoracic pathology.

CASE PRESENTATION: We report the case of a 76-year-old female with a remote history of hiatal hernia repair who developed chronic gastrointestinal symptoms associated with pneumoperitoneum and PCI, complicated by a bronchoperitoneal fistula. While the most bronchoperitoneal fistulas reported are due to thoracic pathology, we suggest that in this case, the fistula may be associated with PCI-related pneumoperitoneum.

CONCLUSIONS

The case demonstrates unique clinical and diagnostic features and raises the possibility of an atypical pathophysiologic association for broncho-peritoneal fistula formation.