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Pneumatosis in Scleroderma Of the Small Bowel

William D. White, MD; Thomas R. Treece, MD; Kerrison Juniper Jr., MD
JAMA. 1970;212(6):1068. doi:10.1001/jama.1970.03170190082021.
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To the Editor.—  Pneumatosis cystoides intestinalis is a rare complication of scleroderma of the small bowel. Previous reports have indicated that this late complication heralds a poor prognosis.1 We have observed one patient with pneumatosis for more than 6 1/2 years. This case is presented to suggest that this complication of intestinal scleroderma does not necessarily indicate a poorer life expectancy.

Report of a Case.—  A 48-year-old Negro housewife was seen in the Medical Clinic in March 1959. Dysphagia, tightness of the skin of the hands, Raynaud's phenomenon, and multiple joint stiffness had been present for one year. An esophagogram revealed a dilated esophagus with lack of peristalsis. A mecholyl test demonstrated lack of sensitivity of the esophagus. The hemoglobin level was 11 gm/100 with a sedimentation rate of 51 mm/hr. During the next four years, the patient was treated for reflux esophagitis with stricture formation. In May 1963,

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