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PubMedDate not supplied

Pneumatosis intestinalis. Appearance on MR examination.

We describe the magnetic resonance (MR) appearance of pneumatosis intestinalis in two patients. Pneumatosis is suggested by the finding of circumferential collections of air adherent or within the bowel wall. This air is more apparent on gradient-echo images due to "blooming" associated with magnetic field inhomogeneities at air-tissue interfaces. While MR is not routinely indicated as a diagnostic tool for the detection of pneumatosis, the radiologist should nevertheless be familiar with its appearance on MR examination.

Adult↗
PubMed1992

Case report: pneumatosis intestinalis occurring in association with cryptosporidiosis and HIV infection.

We report a case of pneumatosis intestinalis (PI) occurring in association with cryptosporidiosis in a patient documented as being HIV-seropositive. Chest and abdominal radiographs taken 2 months previously were normal and the patient did not have any evidence of gastrointestinal infection at that time. The case was complicated by cyst rupture resulting in a pneumoretroperitoneum and pneumomediastinum. The association of pneumatosis and cryptosporidiosis has not been previously reported.

Adult↗
PubMed1998

Asymptomatic pneumatosis intestinalis and free abdominal air in a patient with AIDS.

Detection of free abdominal air requires in most cases immediate surgical intervention. However, there may be situations, where invasive procedures are not indicated. We present a case of asymptomatic pneumatosis intestinalis and free abdominal air in a patient with Aids. Pneumatosis intestinalis is a rare entity with accumulation of subserosal or submucosal gas occurring in the small or large bowel. It has been reported in a variety of gastrointestinal disorders, in Aids, after transplantation, with steroid use, and in association with leukemia, lymphoma, vasculitis, collagen vascular disease and chronic obstructive pulmonary disease.

Abdomen↗
PubMed1979

Pneumatosis oculi and spontaneous hyphema in association with pneumatosis intestinalis.

A premature infant with acute necrotizing enterocolitis, Escherichia coli sepsis, and disseminated intravascular coagulation developed spontaneous bilateral hyphemas at 3 days of age. The necrotizing enterocolitis was associated with gas bubbles in the intestinal walls. The anterior chambers of both eyes also contained bubbles of gas, formed possibly by a mechanism similar to those in the intestine.

Air↗
PubMed1994

Indications for surgical intervention for gastrointestinal emergencies in children receiving chemotherapy.

BACKGROUND: Abdominal pain in children receiving chemotherapy for cancer presents the clinician with unique problems due to the altered immunity of these patients or to the oncologic setting. The major clinical decisions regarding these patients are to determine if and when operative intervention is indicated. METHODS: A retrospective study was done to examine the clinical, radiographic, and laboratory findings that indicate the need for surgical intervention. Sixty-eight of 1090 children who underwent treatment for cancer from October 1982 to December 1990 developed abdominal complaints requiring them to be hospitalized. Nineteen of these patients underwent exploratory laparotomy (operative), and the other 49 were observed (nonoperative). RESULTS: No significant differences were observed in the phase of chemotherapy, treatment with vincristine or corticosteroids, or the hematologic indices between the operative and nonoperative groups. Eighteen of nineteen patients survived their surgeries. Seventeen (89%) of these laparotomies were positive based on the surgical pathology and the operative report. Peritoneal signs on physical examination (P < 0.001) or pneumatosis intestinalis on abdominal radiographs correlated with positive laparotomies (P = 0.001). CONCLUSIONS: Peritoneal signs on physical examination or pneumatosis intestinalis on abdominal X-rays were associated with and specific for the presence of acute surgical disease of the abdomen in immunocompromised pediatric oncology patients.

Abdomen, Acute↗
PubMed1994

[Pneumatosis intestinalis: a rare and difficult problem].

We present a case of a 74-year-old-woman who developed 3 episodes of intestinal pneumatosis, 2 times complicated by pneumoperitoneum, with consequent lethal outcome after 4 months. Intestinal pneumatosis, according to the literature, is a difficult and rare problem, associated with a large number of current diseases, can be complicated by pneumoperitoneum, mostly without clear etiology, whose treatment remains empirical (antibiotics, O2-therapy), not excluded laparotomy, if the clinical situation requires it.

Aged↗
PubMed2003

Pneumatosis coli, a benign form of necrotising enterocolitis.

Necrotising enterocolitis (NEC) is the most common acquired gastrointestinal emergency in neonates. Presence of pneumatosis intestinalis is taken as evidence of definite NEC. A distinctive but rare form of NEC called "pneumatosis coli" has been described, presenting with gross blood in stools and minimal or absent local and systemic signs. Radio-graph characteristically reveal isolated colonic pneumatosis without small bowel involvement. Pneumatosis coli has a more benign course compared with definite NEC. Total parenteral nutrition, antibiotics, an appropriate duration off feeds and close observation remain the corner stones of therapy assuring a benign course.

Colonic Diseases↗
PubMed1994

Pneumatosis intestinalis in a child with AIDS and pseudomembranous colitis.

Pneumatosis intestinalis (PI) was first reported in three children and one adult with acquired immune deficiency syndrome (AIDS) in 1990. The microorganisms cultured from these patients included Cryptosporidium, rotavirus, cytomegalovirus, and Pseudomonas. We report the fourth child with AIDS and PI, and the first with PI to be associated with Clostridium difficile colitis.

AIDS-Related Opportunistic Infections↗
PubMed1976

Necrotizing enterocolitis with recurrent hepatic portal venous gas.

Two separate episodes of pneumatosis intestinalis and hepatic portal venous gas were observed in a premature infant with necrotizing enterocolitis. Although HPVG has previously been considered an ominous roentgenographic sign, the infant survived without surgical intervention. As in several cases reported by others, clinical and roentgenographic signs of NEC reappeared when enteric feedings were restarted prior to 10 days of medical therapy.

Diseases in Twins↗
PubMed2002

The significance of pneumatosis intestinalis or bowel perforation in patients with gynecologic malignancies.

OBJECTIVES: The objectives of this study were to evaluate the clinical significance and outcome of pneumatosis intestinalis or bowel perforation in patients with gynecologic malignancies. METHODS: A retrospective review of all gynecologic oncology patients at our institution from 1996 to the present was performed to identify computed tomography examinations showing pneumatosis, free air, or the presence of portal venous gas. Admission symptoms, laboratory testing, radiographic and operative findings, and overall survival were evaluated. At the discretion of the attending gynecologic oncologist, patients were managed either surgically or conservatively. Statistical analysis was performed with Fisher's exact test. RESULTS: Twenty-eight patients met study criteria. Thirteen patients were excluded as a result of radiographic free air immediately following surgery, thus leaving 15 patients for analysis. Sixty percent (n = 9) of patients were managed surgically while 40% (n = 6) were managed conservatively. Pain and tenderness at presentation prompted surgical intervention in a statistically significant number of patients (P = 0.04). No other sign or symptom was significant. Of the 6 patients managed conservatively, 3 (50%) died within 1 week of diagnosis. Survival for the others was 2, 4, and 6 months. Of the 9 patients managed surgically 6 (67%) patients died, 4 within 2 weeks of surgery and the remainder at 2 and 12 months postoperatively. The 3 patients who survived all had surgical intervention and none had radiographic or pathologic evidence of cancer at the time of presentation (P = 0.01). Overall mortality at 6 months was 73% (11/15). Surgical management was associated with prolonged ICU care, mechanical ventilation, and sepsis. CONCLUSIONS: Pneumatosis intestinalis and bowel perforation carry a grave prognosis for patients with gynecologic malignancies. These data suggest that patients explored for radiographic evidence of pneumatosis or perforation with preoperative evidence of active malignancy do not survive the immediate postoperative period. The balance between quality and quantity of life must be considered when weighing the options for the management of this condition.

Adult↗
PubMed1984

Computed tomography of pneumatosis intestinalis.

Four cases of pneumatosis intestinalis detected by computed tomography (CT) are described. Plain abdominal films obtained on the same day as CT failed to show pneumatosis in three of the four cases. The CT appearances characteristic of pneumatosis intestinalis are cystic, linear, or curvilinear gas collections in the periphery of distended, partly fluid-filled loops of bowel. Two of the four cases had underlying bowel infarction. Evidence of pneumatosis should be carefully looked for in patients with acute abdominal pain referred for CT examination. Computed tomography may be a useful modality for the early diagnosis of bowel ischemia when plain abdominal films are noncontributory.

Abdomen, Acute↗
PubMed1994

Pneumatosis intestinalis with free air mimicking intestinal perforation in a bone marrow transplant patient.

A case of pneumatosis intestinalis with perforation is reported in a patient after bone marrow allograft for chronic myeloid leukemia. Risk factors included the transplant, prolonged immunosuppression and neutropenia, graft-versus-host disease, extended use of corticosteroids, infection and lower gastrointestinal endoscopic biopsy. The literature is reviewed and a management plan for patients presenting with this complication is discussed.

Adult↗
PubMed2001

Lactulose-induced pneumatosis intestinalis and pneumoperitoneum.

A case of PI in a 57-year-old patient with colonic inertia treated with lactulose for PSE secondary to cirrhosis is described. The colonic inertia led to longer transit time. Retained lactulose and a build-up of carbon dioxide and hydrogen gas occurred in the setting of altered bacterial flora deficient in hydrogen metabolism. The increased gas pressure caused extravasation of air into the intestine, causing PI with pneumoperitoneum. They both resolved with discontinuation of lactulose.

Humans↗
PubMed1990

Pneumatosis intestinalis in AIDS: an unreported complication.

Pneumatosis intestinalis (PI) was first described by DuVernou in 1730. Since then, there have been reports of a benign form of PI occurring in both children and adults. Pneumatosis has been associated with a great many diseases, but to our knowledge there are no reports of pneumatosis in patients with acquired immune deficiency syndrome (AIDS). In this paper we report the incidental finding of PI in an AIDS patient. With ever-increasing numbers of AIDS patients, this entity may be seen more often, and clinicians should be aware of its clinical significance.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Pneumatosis intestinalis associated with needle catheter jejunostomy tubes: CT findings and implications.

The CT findings of pneumatosis intestinalis (PI) associated with needle catheter jejunostomy tubes (NCT) are described in two patients. Each case had cyst-like intramural gas collections associated with the NCT. Neither case had focal bowel wall thickening or portal or mesenteric free air, and there was no evidence of intestinal necrosis. Our findings suggest that cyst-like intramural gas collections associated with NCT represent a benign form of PI.

Catheters, Indwelling↗
PubMed2003

Pneumatosis intestinalis in patients with ischemia: correlation of CT findings with viability of the bowel.

OBJECTIVE: The purpose of our study was to reassess the CT finding of pneumatosis in intestinal ischemia to determine whether it indicates transmural necrosis versus partial mural ischemia and also to determine whether other CT findings can be used to predict which patients with pneumatosis are likely to have viable bowel. CONCLUSION: The CT finding of pneumatosis does not always indicate transmural infarction of the bowel in intestinal ischemia. Patients with associated portomesenteric venous gas are more likely to have transmural infarction than those with pneumatosis alone.

Adult↗
PubMedDate not supplied

Massive pneumatosis intestinalis and subcutaneous emphysema: complication of needle catheter jejunostomy.

The safety and efficacy of enteral feeding by needle catheter jejunostomy has prompted its use after many major gastrointestinal operations. Indeed, the technical complications of this procedure are infrequent. This report details the development of massive pneumatosis intestinalis associated with elemental feeding via jejunostomy. The proposed etiology includes excessive gas accumulation within the small intestine secondary to 1) inadequate nasogastric suction, 2) post-traumatic intestinal ileus, and 3) disaccharide fermentation; combined with a mucosal defect created by the catheter jejunostomy. Successful management consists of nasogastric suction and immediate termination of the enteral feeding.

Adult↗
PubMedDate not supplied

Gastric pneumatosis in neonates: revisited.

Pneumatosis intestinalis, found commonly in neonatal necrotising enterocolitis (NEC), can occur in any part of the gastrointestinal tract, from the oesophagus to the rectum. Gastric pneumatosis, defined as air within the wall of the stomach, however, is an extremely rare sign during infancy and is usually secondary to gastric outlet obstruction. The clinical course and outcome of a neonate with gastric pneumatosis associated with NEC is reported along with a brief review of the literature. The findings illustrate that gastric pneumatosis can be the presenting feature of fulminant NEC and may indicate widespread, severe gastrointestinal insult.

Enterocolitis, Necrotizing↗