A Rare Case of Pneumatosis Cystoides Intestinalis in a Patient with Chronic Appendicitis

Abstract: Chronic appendicitis is a common cause of recurrent right lower quadrant pain and is often difficult to diagnose because of its nonspecific presentation. Pneumatosis cystoides intestinalis (PCI), a rare condition characterized by gas-filled cysts in the intestinal wall, is usually associated with other gastrointestinal disorders. We report a 43-year-old woman with a one-year history of intermittent abdominal discomfort who was found to have chronic appendicitis with concurrent PCI, an unusual combination that created diagnostic uncertainty. Computed tomography revealed gas in the appendiceal region and adjacent bowel wall. Colonoscopy and laparoscopic appendectomy were subsequently performed, excluding other gastrointestinal lesions and confirming chronic appendicitis on histopathology. The patient recovered well after surgery, and follow-up imaging 6 months later showed complete resolution of PCI. This report contributes valuable insights into the complex relationship between chronic appendicitis and PCI. Awareness of this association may help improve diagnosis and management. Keywords: chronic appendicitis, pneumatosis cystoides intestinalis, case report, gastrointestinal perforation, differential diagnosis