LAUSR

A 68-year-old woman presented for outpatient screening colonoscopy. She had a medical history of bradycardia and hypothyroidism, and a surgical history of lumpectomy and partial thyroidectomy. Physical examination was normal and vital signs were within normal limits. Pertinent laboratory tests were within reference range. Colonoscopy revealed multiple sessile pseudopolyps with normal overlying mucosa in the sigmoid colon. Pseudopolypoid lesions deflated after biopsy puncture and upon aspiration with sclero-needle. Histopathology revealed hyperplastic changes with no evidence of dysplasia (Fig. 1). The above findings were consistent with the diagnosis of pneumatosis cystoides coli. Pneumatosis cystoides coli is characterized by the presence of gas-containing cysts within the submucosal or subserosal layer of the bowel wall. Pneumatosis cystoides coli typically occurs in adults and can present as focal or diffuse lesions of the colon. Though usually asymptomatic, it can lead to obstruction, pneumoperitoneum, and intermittent or persistent pain. Though the pathophysiology of this condition is not clear, it can be associated with inflammatory bowel disease and systemic sclerosis, as well as endoscopic procedures, mechanical ventilation, and tube feeds which may cause a tear in the intestinal mucosal wall introducing gas-producing microbes. Mild cases are managed conservatively, while