LAUSR

A 78-year-old male presented with a 6-months complain of progressive dysphagia for solids and liquids. He had a previous medical history of chronic obstructive pulmonary disease (COPD) and arterial hypertension and had been previously diagnosed and successfully treated for pulmonary tuberculosis. He also had been submitted to an upper gastrointestinal endoscopy 2 years previously for heartburn, with no abnormalities. The patient reported no other symptoms, and physical examination was unremarkable. Laboratorial analysis showed normal hemogram values, as well as ionogram, renal and liver function, and normal albumin and total serum proteins. A thorax CT-scan, performed a few days earlier for COPD evaluation, revealed a moderate parietal thickening of the esophagus, more pronounced in its middle third, with subserosal small cystic collections of air (Fig. 1). We performed an upper gastrointestinal endoscopy, revealing numerous, coalescent and easily depressible mucosal protrusions along the entire esophagus, without significant luminal stenosis, compatible with pneumatosis of the gastrointestinal tract (Fig. 2). Both the stomach and duodenum were endoscopically normal. Following the procedure, a conservative management was decided, and the patient remained as outpatient without directed treatment, with significant clinical improvement during the next 6 months. Pneumatosis of the gastrointestinal tract (PGIT) is an uncommon disease, of unknown origin, characterized by the presence of gas within the intestinal wall.1 Despite the fact that the first case of PGIT was described in 1730, by Du Vernoi, it is still poorly understood and seldom studied. Both genders are equally affected by this disease, most frequently in the forth and fifth decades,2 and although it may affect any segment of the gastrointestinal tract, from the esophagus to the rectum, it is far more frequent in the colon