Pneumatosis intestinalis: benign or life‐threatening?

2019 ◽  
Vol 90 (9) ◽  
pp. 1790-1792
Author(s):  
Chi Lap Nicholas Tsang ◽  
Christopher Seng Hong Lim ◽  
Michelle Zhiyun Chen ◽  
Yeng Kwang Tay ◽  
Kim‐Chi Phan‐Thien
Keyword(s):  
Pneumatosis Intestinalis ◽  
Life Threatening

scholarly journals Benign versus life-threatening causes of pneumatosis intestinalis: differentiating CT features

2018 ◽  
Vol 64 (6) ◽  
pp. 543-548 ◽  
Author(s):  
Sujin Ko ◽  
Seong Sook Hong ◽  
Jiyoung Hwang ◽  
Hyun-joo Kim ◽  
Yun-Woo Chang ◽  
...  
Keyword(s):  
Bowel Wall ◽  
Statistical Significance ◽  
Pneumatosis Intestinalis ◽  
Bowel Distension ◽  
Wall Defect ◽  
Ct Findings ◽  
Free Air ◽  
Appropriate Treatment ◽  
Life Threatening ◽  
Ct Features

SUMMARY OBJECTIVE: To assess the diagnostic performance of CT findings in differentiating causes of pneumatosis intestinalis (PI), including benign and life-threatening causes. METHODS: All CT reports containing the word “pneumatosis” were queried from June 1st, 2006 to May 31st, 2015. A total of 42 patients with PI were enrolled (mean age, 63.4 years; 23 males and 19 females) and divided into two groups on based on electronic medical records: a benign group (n=24) and a life-threatening group (n=18). Two radiologists reviewed CT images and evaluated CT findings including bowel distension, the pattern of bowel wall enhancement, bowel wall defect, portal venous gas (PVG), mesenteric venous gas (MVG), extraluminal free air, and ascites. RESULTS: CT findings including bowel distension, decreased bowel wall enhancement, PVG, and ascites were more commonly identified in the life-threatening group (all p<0.05). All cases with PVG were included in the life-threatening group (8/18 patients, 44.4%). Bowel wall defect, extraluminal free air, and mesenteric venous gas showed no statistical significance between both groups. CONCLUSION: PI and concurrent PVG, bowel distension, decreased bowel wall enhancement, or ascites were significantly associated with life-threatening causes and unfavorable prognosis. Thus, evaluating ancillary CT features when we encountered PI would help us characterize the causes of PI and determine the appropriate treatment option.

scholarly journals Pneumatosis intestinalis an increasingly common radiological finding, benign or life-threatening? A case series

2015 ◽  
Vol 2015 (feb18 1) ◽  
pp. bcr2014207234-bcr2014207234 ◽  
Author(s):  
H. A. Blair ◽  
R. Baker ◽  
R. Albazaz
Keyword(s):  
Radiological Finding ◽  
Case Series ◽  
Pneumatosis Intestinalis ◽  
Life Threatening

scholarly journals Distinguishing Benign and Life-Threatening Pneumatosis Intestinalis in Patients With Cancer by CT Imaging Features

2013 ◽  
Vol 200 (5) ◽  
pp. 1042-1047 ◽  
Author(s):  
Kyungmouk Steve Lee ◽  
Sinchun Hwang ◽  
Sandra M. Hurtado Rúa ◽  
Yelena Y. Janjigian ◽  
Marc J. Gollub
Keyword(s):  
Pneumatosis Intestinalis ◽  
Ct Imaging ◽  
Imaging Features ◽  
Patients With Cancer ◽  
Life Threatening

A Review of Pneumatosis Intestinalis in the Setting of Systemic Cancer Treatments, Including Tyrosine Kinase Inhibitors

2012 ◽  
Vol 63 (4) ◽  
pp. 312-317 ◽  
Author(s):  
Niranjan Vijayakanthan ◽  
Kavita Dhamanaskar ◽  
Lori Stewart ◽  
Jodie Connolly ◽  
Brian Leber ◽  
...  
Keyword(s):  
Tyrosine Kinase ◽  
Cancer Treatment ◽  
Tyrosine Kinase Inhibitors ◽  
Kinase Inhibitors ◽  
Pneumatosis Intestinalis ◽  
Abdominal Imaging ◽  
Cytotoxic Agents ◽  
Novel Therapies ◽  
Cancer Treatments ◽  
Life Threatening

Purpose Pneumatosis intestinalis is a radiologic diagnosis that manifests in a variety of clinical settings. We report 4 cases of pneumatosis intestinalis in patients undergoing cancer treatments that included cytotoxic agents and/or tyrosine kinase inhibitors. These reports aim to provide insight into the clinical interpretation and pathogenesis of pneumatosis intestinalis in the setting of cancer treatments and demonstrate a potential association with tyrosine kinase inhibitors. Methods Radiologists responsible for the interpretation of adult imaging at our tertiary care centre were surveyed to identify cases of pneumatosis intestinalis arising in the midst of cancer treatment. The case histories were reviewed by physicians with expertise in cancer treatment. Results Four cases of chemotherapy-related pneumatosis intestinalis were identified. The diagnosis was made in 1 patient during investigations undertaken for non–life-threatening abdominal symptoms and incidentally in 2 patients by abdominal imaging used to measure chemotherapy response. A fourth patient presented in a life-threatening manner, and abdominal imaging was symptom guided. Interestingly, 3 of the 4 patients were receiving treatments that included a tyrosine kinase inhibitor, and this agent was the only identifiable potential etiology in 1 patient. Conclusions The significance of pneumatosis intestinalis arising during cancer treatments is difficult to interpret because of the complex nature of the diseases and the treatments that often include combinations of cytotoxic agents and/or novel therapies. These reports demonstrate the importance of classifying this radiologic finding according clinical severity rather than etiology and underscore the need for continued observation for unexplained adverse effects when using novel therapies.

Necrotizing Enterocolitis

2018 ◽  
Author(s):  
Jared Hylton ◽  
Sarah Deverman
Keyword(s):  
Necrotizing Enterocolitis ◽  
Neonatal Intensive Care ◽  
Clinical Presentation ◽  
Pneumatosis Intestinalis ◽  
Postoperative Management ◽  
First Line ◽  
Surgical Emergencies ◽  
Threatening Condition ◽  
Life Threatening ◽  
Ventilatory Management

Necrotizing enterocolitis (NEC) is a potentially life-threatening condition that affects mainly preterm infants. It is one of the most common surgical emergencies in the neonatal intensive care unit. While medical management is the first line of treatment, if that fails, NEC becomes a surgical emergency, and the pediatric anesthesiologist must be prepared. This chapter covers the pathogenesis, risk factors, clinical presentation and diagnosis, prevention, medical and surgical management, pre- and intraoperative anesthetic assessment, and postoperative management of NEC. Topics covered include intestinal perforation, necrotizing enterocolitis, neonatal anesthesia, pneumatosis intestinalis, prematurity, and ventilatory management. The chapter ends with review questions on the chapter’s content.

scholarly journals Intramural Gas: Would it be Life-threatening?

2020 ◽  
pp. 63
Author(s):  
Azna Aishath Ali ◽  
Syamim Johan ◽  
Firdaus Hayati ◽  
Chiak Yot Ng
Keyword(s):  
Bowel Wall ◽  
Neoadjuvant Treatment ◽  
Gas Bubbles ◽  
Pneumatosis Intestinalis ◽  
Hepatic Flexure ◽  
Life Threatening ◽  
Rectal Mass ◽  
Localized Disease ◽  
Cect Scan ◽  
Intramural Gas

The CECT scan of the abdomen at axial and coronal views show gas bubbles tracking along the inner wall of the ascending colon and hepatic flexure, which is separated from the intraluminal gas within the bowel. These intramural gas bubbles appear to be outlining the bowel wall circumferentially. The bowel wall appears to be thickened however the inner mucosa is not enhanced. There are no ascites in the images provided. The colon of the hepatic flexure and transverse colon appears dilated. No significant atherosclerotic plaque in the visualised arteries. Based on the clinical presentations and CECT features in Figure 1 and Figure 2, the best diagnosis for him is benign pneumatosis intestinalis (PI) secondary to obstructed low rectal cancer. He was subjected for a trephine transverse colostomy to relieve the obstruction with simultaneous transanal rectal mass biopsy. Once the histology is available, he subsequently will be referred for concurrent chemo-radiotherapy as neoadjuvant treatment and later for a low anterior resection, provided that it is a localized disease.

scholarly journals Pneumatosis intestinalis: Diagnosis by endoscopic ultrasound-guided puncture

2016 ◽  
Vol 07 (03) ◽  
pp. 110-111
Author(s):  
Rafie A. Yakoob ◽  
Manik Sharma ◽  
Hamid U. Wani
Keyword(s):  
Endoscopic Ultrasound ◽  
Pneumatosis Intestinalis ◽  
Ultrasound Guided ◽  
Life Threatening ◽  
Thin Walled ◽  
Ultrasound Guided Puncture ◽  
Guided Puncture

AbstractPneumatosis intestinalis (PI) has been found in association with multiple benign and life-threatening conditions. Primary PI is a benign idiopathic condition in which multiple thin-walled cysts develop in the colon. Most often, this form has no symptoms and is detected incidentally during radiography or endoscopy for other reasons. When the cysts protrude into the lumen, they may mimic polyps or carcinoma. Endoscopic ultrasound can be used to confirm the diagnosis before attempting polypectomy or snare biopsy of the lesions.

Pneumatosis Intestinalis in the Adult: Benign to Life-Threatening Causes

2007 ◽  
Vol 188 (6) ◽  
pp. 1604-1613 ◽  
Author(s):  
Lisa M. Ho ◽  
Erik K. Paulson ◽  
William M. Thompson
Keyword(s):  
Pneumatosis Intestinalis ◽  
Life Threatening

Pneumatosis in Post-Whipple Patients

2012 ◽  
Vol 78 (10) ◽  
pp. 1105-1108
Author(s):  
Lauren I. Wikholm ◽  
David K. Imagawa
Keyword(s):  
Strong Predictor ◽  
Pneumatosis Intestinalis ◽  
Feeding Tube ◽  
Reoperation Rate ◽  
Whipple Procedure ◽  
Exact Test ◽  
Lethal Complications ◽  
Life Threatening ◽  
Necrotic Bowel ◽  
The Difference

Pneumatosis intestinalis (PI) is the finding of air in the wall of the intestine. Clinical significance ranges from an incidental radiologic finding to an indicator of life-threatening disease requiring surgical intervention. We report the incidence and consequence of PI in a 7-year, single-surgeon, retrospective review. Data from demographics, imaging, and outcomes were analyzed. Two-tailed Fisher's exact test was performed to analyze the difference between groups. A total of 214 patients underwent a Whipple procedure with a routinely placed feeding tube during this period. Most had a gastrojejunal feeding tube, 80.4 per cent. Thirteen patients developed PI. Overall reoperation rate was nine of 201 versus four of 13 in the PI group ( P < 0.02). Three patients taken back to the operating room with peritonitis and PI had a necrotic bowel. A fourth patient was taken to surgery for unrelenting upper gastrointestinal bleeding. The remaining nine were managed nonoperatively with resolution of PI. The 90-day death rate in those without PI was 2.9 per cent versus 23.3 per cent with PI ( P < 0.02). Isolated PI can be managed nonoperatively; however, in the presence of peritonitis, it is a strong predictor of lethal complications.

scholarly journals Atypical enteritis causing life-threatening pneumatosis intestinalis in a dog – radiographic and ultrasonographic findings

2021 ◽  
Vol 90 (5) ◽  
pp. 245-251
Author(s):  
G. Mampaey ◽  
G. Schils ◽  
A. Schlake ◽  
S. Marynissen ◽  
E. Vandermeulen
Keyword(s):  
Clinical Signs ◽  
Pneumatosis Intestinalis ◽  
Abdominal Ultrasound ◽  
Explorative Laparotomy ◽  
Life Threatening ◽  
Abdominal Radiographs ◽  
Small Intestinal ◽  
One Year

A geriatric dog was presented for acute vomiting, anorexia and lethargy. Abdominal ultrasound was suggestive of the presence of gas within the small intestinal walls. Additional abdominal radiographs confirmed the ultrasonographic abnormalities, compatible with pneumatosis intestinalis. Explorative laparotomy revealed hemorrhagic lesions, thickened intestinal walls and serosal discoloration of the jejunum. Partial jejunectomy was performed and histopathology showed findings compatible with atypical bacterial enteritis. The dog recovered completely and did not show any clinical signs during a follow-up period of one year after surgery.

Sign in / Sign up

Export Citation Format

Share Document