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At least 685 records · Page 38Linked to original sources
PubMed1978

Fulminant necrotising enterocolitis associated with Clostridia.

5 infants with no growth of bacteria on cultures of blood and peritoneal fluid recovered from necrotising enterocolitis after medical treatment alone. 12 infants with positive cultures required surgery. 5 of these 12, who did not harbour clostridia, had a mild clinical course and all 5 survived segmental bowel resection. The 7 infants who harboured clostridia had a more severe clinical course and 4 died. In 3 of 4 infants with Clostridium perfringens, the necrotising enterocolitis was fulminant, characterised by severe pneumatosis intestinalis, extensive gangrene, early intestinal perforation, and a fatal outcome.

Ascitic Fluid↗
PubMed1979

The clinical and radiological evaluation of neonatal necrotising enterocolitis in Benin City, Nigeria.

Twenty four cases of neonatal necrotising enterocolitis seen at the University of Benin Teaching Hospital over a two year period are analysed. The clinical features of this entity were characterised by abdominal distension, apnoeic attacks, refusal to feed, bloody diarrhoea and fever. Seventeen infants (71%) were preterm. The important radiologic findings on plain abdominal films were pneumatosis intestinalis, pneumoperitoneum, abdominal distension and gas in the portal venous system. Twenty two of the 24 infants were treated conservatively. There was an overall mortality of 75%. The main pathologic findings were coagulation necrosis, mucosal ulceration and pneumatosis intestinalis. The roles of asphyxia, umbilical venous catherisation and septicaemia are stressed.

Enterocolitis, Pseudomembranous↗
PubMed1999

Gas at abdominal US: appearance, relevance, and analysis of artifacts.

PURPOSE: To describe the spectrum of ultrasonographic (US) appearances of intraluminal gas, including two clinically relevant gas artifacts. MATERIALS AND METHODS: Observations were made in patients and reproduced in an animal model, an ex vivo gut preparation, and a tissue-mimicking phantom. Appearances were classified according to a physical model of the interaction between sound and collections of gas. RESULTS: Free bubbles of gas appeared as bright echogenic foci extending artifactually owing to lateral and axial blooming. This causes bubbles that abut the gut wall to enhance the layer one echo, which corresponds to the interface between the mucosa and the luminal contents. Such bubbles can also falsely appear to be within the gut wall itself owing to elevation averaging and thereby cause the artifact pseudo-pneumatosis intestinalis. Isolated groups of small bubbles created a characteristic periodicity and tapering of the distal echo pattern. In the extreme case, in which many such echoes are superimposed, "dirty shadowing" occurs. A contiguous pocket of gas may cause the gut wall to appear artifactually thickened (i.e., pseudo-thickened gut). This was shown to be a form of mirror image artifact. CONCLUSION: Classification of the effects of gas on US images according to their physical characteristics may aid in their interpretation. Appreciating two previously undescribed artifacts, pseudo-pneumatosis intestinalis and pseudo-thickened gut, will improve the usefulness of abdominal US.

Abdomen↗
PubMed1989

Pneumatosis intestinalis in bone-marrow transplantation patients: diagnosis on routine chest radiographs.

We report seven cases of pneumatosis intestinalis that was initially detected on routine chest radiographs made in adult bone-marrow transplantation patients. The cases were collected over a 13-month period. The chest radiographs generally underestimated the extent of the pneumatosis, as subsequently seen on plain abdominal films. However, the portions of bowel most extensively involved were those seen on the chest radiographs (transverse colon, hepatic and splenic flexures, stomach). One patient had pneumoperitoneum also. Pneumatosis developed within 6-293 days after transplantation. The cause of pneumatosis intestinalis was multifactorial. Three patients were asymptomatic. Clinical management of all seven patients was altered because of the detection of pneumatosis. The dose of steroids was increased in three patients to treat graft-vs-host disease, antibiotic drugs were given to three patients for enteric pathogens, and bowel rest was prescribed for one patient with mucosal injury from intense chemotherapy and radiation therapy. These cases show that the chest radiograph makes early diagnosis of pneumatosis intestinalis possible in posttransplantation patients.

Adult↗
PubMed2001

[Pneumatosis intestinalis after allogeneic bone marrow transplantation for acute lymphocytic leukemia].

A 45-year-old man was diagnosed as having acute lymphocytic leukemia (ALL) in February 1997. Complete remission was achieved by chemotherapy, and allogeneic BMT from his HLA-identical sister was performed on November 13, 1997. He developed acute GVHD (grade II), but quickly recovered after methyl-PSL pulse therapy. On June 5, 1998--day 202 after BMT--abdominal pain developed. X-ray and CT examinations showed pneumatosis intestinalis, pneumoperitoneum, pneumomediastinum and abdominal free air. We performed oxygen administration and methyl-PSL pulse therapy, and this quickly improved the symptoms. Corticosteroid and chronic GVHD were thought to be the causative factors of pneumatosis intestinalis in this case. Although pneumatosis intestinalis is relatively rare, it is one of the important potential complications that can occur after allogeneic BMT.

Bone Marrow Transplantation↗
PubMed2003

Pneumatosis intestinalis and diarrhea in a child following renal transplantation.

Pneumatosis intestinalis is an uncommon finding beyond the neonatal period, but it has been reported in immunocompromized pediatric patients. The association of pneumatosis intestinalis in children following renal transplantation has to the best of our knowledge been only reported once in children. We describe a 4-year-old female who developed intermittent emesis, weight loss, and intermittently loose bloody stools after cadaveric renal transplantation at age 3.5 years. An abdominal x-ray demonstrated extensive pneumatosis in the colon. The infectious work-up was negative. Histologically, she had increased eosinophils throughout the lamina propria in the rectum. A glucose breath test was suggestive of small bowel bacterial overgrowth. She was treated with 10 days of metronidazole with resolution of the diarrhea and occult blood in stools. One month after the treatment she had radiologic resolution of her pneumatosis. Based on this report, pneumatosis intestinalis should be considered in the differential diagnosis of children after organ transplant suffering from diarrhea, abdominal pain, or blood in the stool.

Cadaver↗
PubMed2003

Necrotizing enteritis with hepatic portal venous gas and pneumatosis intestinalis: report of a case.

A 73-year-old woman visited our hospital because of increasing abdominal distension and lower abdominal pain. On abdominal computed tomography (CT), hepatic portal venous gas (HPVG) and pneumatosis intestinalis of the small intestine were found. HPVG caused by intestinal necrosis was diagnosed, and an emergency laparotomy was thus performed. Necrosis of the small intestine over a 40-cm area from the ileocaecal region toward the mouth was found, and the lesion was resected. Histopathologically, haemorrhagic necrotic enteritis was diagnosed. The patient is alive as of the seventieth day after operation. The prognosis of intestinal necrosis accompanied by HPVG and pneumatosis intestinalis is poor. The presence of HPVG suggests the occurrence of a serious lesion in the abdominal cavity. Therefore, appropriate treatment should be performed immediately.

Aged↗
PubMed2007

Fulminant pneumatosis intestinalis in a patient with diabetes mellitus and minimal change nephrotic syndrome.

We report a case of pneumatosis intestinalis in a diabetic patient with minimal change nephrotic syndrome, receiving immunosuppressive drugs and an alpha-glucosidase inhibitor. The patient was a 72-year-old female, who suffered from right lower abdominal pain. Abdominal CT showed massive air in the intestinal wall, compatible with pneumatosis intestinalis. Her general condition rapidly deteriorated with systemic inflammatory response syndrome. The patient had received respiratory support for a week, along with antimicrobial therapy and continuous hemofiltration, and then recovered. Even though pneumatosis intestinalis is generally recognized as a mild disease, careful attention is necessary when it follows a serious condition.

Aged↗
PubMedDate not supplied

Needle catheter jejunostomy complicated by pneumatosis intestinalis: a case report.

Needle catheter jejunostomy is a technique to allow enteral feeding after upper abdominal surgery. An unusual postoperative complication is pneumatosis intestinalis which can be life-threatening. A case of a 76-year-old man with pneumatosis intestinalis due to needle catheter jejunostomy, in whom diagnosis was made by CT-scan, is described. Needle catheter jejunostomy complicated by pneumatosis intestinalis needs attention and careful treatment. Removal of the catheter seems necessary, although controversy remains.

Aged↗
PubMed1999

[Diagnostic imaging in intestinal pneumatosis].

Abnormal air in intestinal walls, mesentery and portal veins can be caused by serious illness like gangraena or necrosis. It can also accompany other conditions that may be treated conservatively. We describe three patients with pneumatosis intestinalis. Special emphasis is given to imaging techniques, particularly computer tomography. We recommend continuous axial slices and the use of an oral contrast agent. Correct settings of window and level is important for diagnosis of this rare disease.

Adult↗
PubMed2003

[The association of Pneumatosis intestinalis and portal venous gas].

INTRODUCTION: Pneumatosis intestinalis is the presence of air in a wall of a section of the digestive tract. Portal venous gas is a radiological sign that corresponds to the presence of air in the portal vein. Their association, observed among others in certain pathologies such as the blunt abdominal trauma, endoscopic procedures or anaerobic infections, is a factor of severity. OBSERVATION: We report a case of Pneumatosis intestinalis and portal venous gas secondary to uterine gangrene after caesarean operation in a 16 year-old woman. CONCLUSION: Diagnosis of Pneumatosis intestinalis in association with portal venous gas is an emergency indication for surgery in the case of septicaemia, although exhibiting a high rate of complications and mortality.

Adolescent↗