Pneumatosis cystoides intestinalis (PCI) is a rare condition characterized by the presence of multiple gas-filled cysts within the submucosal or subserosal layers of the intestinal wall. Although often asymptomatic and detected incidentally, PCI may be associated with significant underlying gastrointestinal or systemic pathology. We report two young adults from Addis Ababa, Ethiopia, who presented with long-standing upper gastrointestinal symptoms, including early satiety, postprandial epigastric pain, reflux, vomiting, and marked weight loss. Clinical, laboratory, and endoscopic evaluations confirmed gastric outlet obstruction (GOO) secondary to chronic duodenal stenosis. Both patients underwent retrocolic gastrojejunostomy with truncal vagotomy and Braun's anastomosis. During surgery, multiple gas-filled cystic lesions consistent with PCI were incidentally identified on the serosal surface of the small intestine. There were no signs of bowel ischemia, perforation, or peritonitis. No bowel resection was performed, and PCI was managed conservatively. Postoperative recovery was uneventful in both cases, with complete symptom resolution and significant weight gain at follow-up. These cases emphasize that PCI may occur secondary to chronic mucosal disruption and increased intraluminal pressure in GOO. Recognition of PCI in this clinical context is essential to guide appropriate management. When incidentally detected in the absence of complications, PCI does not warrant specific surgical intervention. Management should instead focus on addressing the underlying pathology to avoid unnecessary bowel resection.

Early detection of sacral pressure injuries (PIs) in immobilised polytrauma patients remains challenging. This study evaluated ultrahigh-frequency (UHF) ultrasound combining structural and haemodynamic parameters for early PI diagnosis. In a prospective cohort of 73 polytrauma patients (Injury Severity Score 16-25), daily sacrococcygeal assessments were performed over 15 days using UHF ultrasound (Mindray Resona 11; L20-5 s probe). Parameters included 2D morphology, perfusion (colour power angiography [CPA]), flow metrics (peak systolic velocity [PSV]), Braden Scale and inflammatory markers. PI incidence was 27.4% (n = 20; all stage I/II). Haemodynamic markers outperformed 2D ultrasound: CPA grade ≥ 1 (AUC = 0.858, 80.0% sensitivity) and PSV > 5.55 cm/s (AUC = 0.841, 95.0% sensitivity). Combined CPA + PSV achieved superior accuracy (AUC = 0.922). Systemic inflammation showed no intergroup differences. UHF ultrasound detects early PIs by capturing ischaemia-reperfusion changes. The CPA + PSV protocol provides nurses with a rapid (< 5 min), sensitive bedside tool to guide proactive interventions.

Venous leg ulcers (VLUs) are a chronic condition with significant healthcare costs. UK clinical guidelines recommend regular physical activity for VLU management, but evidence on its efficacy in promoting healing and preventing recurrence remains limited. This systematic review aimed to evaluate the effectiveness of exercise interventions, in addition to standard care, on VLU outcomes. A comprehensive search of databases was conducted up to May 22, 2025. The review followed PRISMA guidelines and registered on PROSPERO (CRD420251057818). Eligible studies included adults with VLUs and an ankle-brachial pressure index greater than 0.8. Only randomised controlled trials comparing exercise plus standard care with standard care alone and reporting ulcer-related outcomes were included. Nine trials were included, with 133 patients receiving exercise interventions and 137 receiving standard care. All studies combined exercise with compression therapy. Intervention duration ranged from 4 to 12 weeks. A meta-analysis of eight studies showed a significantly higher healing rate in the exercise group (RR = 1.35). Subgroup analysis revealed statistically non-significant higher effect sizes for hospital-based programmes (RR = 1.69) compared to home-based ones (RR = 1.22). Five studies reported ulcer area reduction, with a non-significant pooled standardised mean difference (SMD) of 0.72. No studies reported ulcer recurrence. Both home- and hospital-based exercise programmes appear to improve VLU healing rates when added to standard care, although current evidence is limited by small sample sizes, methodological variability, and lack of recurrence data. Future trials should standardise protocols and include long-term follow-up to guide clinical practice.