Pneumatosis cystoides intestinalis treated under conservative treatment after pancreaticoduodenectomy

The patient was an 84-year-old man who visited our hospital because of diabetes and had a sudden deterioration in blood glucose control. A pancreatic head tumor was pointed out upon examination and he was referred to our department. The contrast CT revealed a tumor of 15 mm in the head of the pancreas. The tumor was in contact with the portal vein, but no invasion into the major artery was observed, and therefore was diagnosed as resectable pancreatic head cancer. Subtotal stomach-preserving pancreaticoduodenectomy with portal vein resection was performed. Abdominal pain appeared on postoperative day 4, and abdominal CT revealed pneumatosis cystoides intestinalis (PCI). Conservative treatment was performed because no findings of intestinal necrosis was found. Subsequent CT revealed improvement of PCI and he was discharged on postoperative day 22 in good general condition. There are few reports on PCI as postoperative complications, especially after pancreaticoduodenectomy. We herein report a case of PCI treated under conservative therapy after subtotal stomach-preserving pancreaticoduodenectomy.