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Pneumatosis cystoides coli and chloral hydrate
  1. J H MARIGOLD
  1. Department of Medicine,
  2. Salisbury District Hospital,
  3. Salisbury, Wiltshire SP2 8BJ, UK

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Editor,—In an interesting paper (Gut 1997;41:778–85), Dr Florin has postulated a causal association between alkyl halides and the development of pneumatosis cystoides coli (PCC). Review of the notes of two patients with this rare condition seen over the past seven years has revealed that both were taking chloral hydrate at the time of diagnosis.

case 1

A 78 year old woman was admitted in February 1991 because of immobility and constipation secondary to longstanding Parkinson’s disease. She was treated with chloral hydrate 500 mg at night for insomnia. In June 1992, she presented with a three month history of intermittent diarrhoea. Flexible sigmoidoscopy suggested mild ulcerative colitis (not confirmed on biopsy) and simultaneous barium enema showed extensive inflammatory polyps up to the proximal transverse colon, with a malignant stricture in the distal sigmoid colon. At laparotomy, no tumour was detected but gas filled cysts …

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