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We experienced a relatively rare case of pneumatosis cytoides coli in which multiple cysts due to gas occurred in the intestinal wall. A 45-year-old woman was admitted to the hospital because of anal bleeding and repeated abdominal pain. She was a painter and had been treated trichlorethelene for more than 20 years. There was no history of paticular disease nor family history. Abdominal X-ray film revealed a honey-comb shadow in the left abdomen. Barium-enema examination revealed many broad-based and smooth-surfaced polypoid lesions all over the sigmoid colon. Endoscopic examination of the colon showed multiple polypoid lesions, which decreased in size upon rupture with forceps. The patient was diagnosed as pneumatosis cystoides intestinalis (PCI) and successfully treated by 14 day oxygen inhalation in a dose of 5l catheter for 5 hours a day. The lesions completely disappeared, and no recurrence has been found for 7 months thereafter. Oxygenation therapy used in this case is excellent in that it can offer a reliable therapeutic effect with shorter period.

A recent 10 year-experience with 40 cases of multiple primary carcinoma of the large intestine and other organs was clinically studied. The 40 cases represented 4.8% of 835 cases operated on for colorectal carcinoma in the same period, including 11 synchronous, 27 heterochronous and 2 synchronous/heterochronous multiple carcinoma cases.Among carcinoma in other organs, gastric carcinoma was the most common (53.5%). Multiple carcinoma cases were more common in males and in elders, and appeared to have a family history of cancer in a higher frequency than the 835 operated cases. The clinicopathological findings of colorectal carcinomas in 32 multiple primary malignant cases with resection of colorectal carcinoma were not so characteristic compared to the 658 resectable cases without carcinoma of other organs. The cumulative 5-year survival rate of the 31 cases with resection of both colorectal carcinoma and carcinoma of other organs was significantly lower than that of 658 resectable cases described above. In order to improve the prognosis of multiple carcinomas, we have to make more effort at improving the prognosis of primary malignant tumors of other organs, especially gastric carcinoma, in synchronous cases, and at detecting early the associated colorectal carcinoma in heterochronous cases, if another carcinoma of other organ preceded.