Estimating the risk of bowel ischemia requiring surgery in patients with tomographic evidence of pneumatosis intestinalis

Umapathi, Bindu A.; Friel, Charles M.; Stukenborg, George J.; Hedrick, Traci L.

doi:10.1016/j.amjsurg.2015.09.010

Cited by 19 publications

(22 citation statements)

References 20 publications

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“…Imaging features, such as pneumatosis intestinalis, can be associated with benign and life threatening conditions [46]. Therefore correlation with validated clinical parameters such as lactic acidosis, abdominal tenderness and tachycardia [47] is required to overcome these limitations, and more accurately predict ischemic bowel at surgery.…”

Section: Limitations Of Ctmentioning

confidence: 99%

Modern imaging techniques in intra-abdominal hypertension and abdominal compartment syndrome: a bench to bedside overview

Sugrue¹,

Malbrain²,

Pereira³

et al. 2018

Anaesthesiol Intensive Ther

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Section: Limitations Of Ctmentioning

confidence: 99%

Modern imaging techniques in intra-abdominal hypertension and abdominal compartment syndrome: a bench to bedside overview

Sugrue¹,

Malbrain²,

Pereira³

et al. 2018

Anaesthesiol Intensive Ther

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“…Therefore, we deemed the degree of PCI not severe and selected conservative therapy. As with HPVG, PCI is not an indicator for surgical resection per se ( 14 ), and no reports have found that the degree of PCI is correlated with the severity of the intestinal ischemia or timing of computed tomography. More case reports are needed to clarify whether the degree of PCI is correlated with the severity of the intestinal ischemia or timing of computed tomography.…”

Section: Discussionmentioning

confidence: 99%

Stenotic Ischemic Enteritis with Concomitant Hepatic Portal Venous Gas and Pneumatosis Cystoides Intestinalis

et al. 2018

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A 69-year-old man was admitted to a hospital with complaints of abdominal pain. Computed tomography showed hepatic portal venous gas and pneumatosis cystoides intestinalis. Conservative treatment was effective; however, after discharge, he developed complaints of vomiting. Fluoroscopic enteroclysis revealed a stricture in the jejunum necessitating admission to our hospital. Transoral balloon-assisted enteroscopy showed a circumferential ulcer with a stricture. The stricture was surgically resected, and a histopathological examination was consistent with ischemic enteritis. Stenotic ischemic enteritis should be considered among the differential diagnoses in a patient presenting with hepatic portal venous gas and pneumatosis cystoides intestinalis showing small intestinal obstruction.

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“…1) of which 9 articles primarily described patients with PI, including some with IBD, while 1 described the prevalence of PI from a population of CD patients (Table 2). [11][12][13][14][15][16][17][18][19][20] There were no differences in data extraction noted between the 2 reviewers. In total, 58 IBD patients with PI were identified.…”

Section: Systematic Reviewmentioning

confidence: 99%

“…Nine articles reported on mortality. [12][13][14][15][16][17][18][19][20] Pooling the data results yielded an overall mortality rate of 22% for patients with PI, but there was no specific data available on mortality in the subset of pa-tients with both PI and IBD. The limited extractable data specific to IBD patients in the studies precluded meta-analysis.…”

Section: Systematic Reviewmentioning

confidence: 99%

Presentation and outcomes among inflammatory bowel disease patients with concurrent pneumatosis intestinalis: a case series and systematic review

et al. 2020

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Background/Aims: Inflammatory bowel disease (IBD) involves chronic inflammation of the colon with ulcerative colitis (UC), and the colon and/or small intestine with Crohn’s disease (CD). Pneumatosis intestinalis (PI), characterized by compromise of the intestinal wall with gas-filled cysts, has rarely been reported with IBD. The presentation, best management and outcomes of PI with IBD are poorly defined. Methods: We conducted a search for PI in all abdominal computed tomography (CT) reports at 2 large tertiary care hospitals from January 1, 2010 to December 31, 2017, cross referenced to ICD codes for IBD. CT and chart review was performed to confirm PI and IBD respectively. A systematic review excluding case reports was performed for PI with IBD for comparison. Results: Of 5,990 patients with a CT abdomen report mentioning PI, we identified 11 cases of PI with IBD, 4 UC, 6 CD, and 1 indeterminate colitis. PI was limited to the small bowel in 5 patients, the right colon in 5, and small bowel and colonic in 1. All 3 mortalities had CD, small intestinal PI and portal/mesenteric venous gas. The systematic literature search identified 9 articles describing 58 patients with IBD and PI. These cases were mostly included in larger cohorts of PI patients without extractable data on presentation or outcomes in the IBD subpopulation. Conclusions: Ours appears to be the first reporting of presentations and outcomes, outside of case reports, for those with PI and IBD. The high mortality for those with CD and PI of the small bowel appears to define a group requiring more than supportive medical care.

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Estimating the risk of bowel ischemia requiring surgery in patients with tomographic evidence of pneumatosis intestinalis

Cited by 19 publications

References 20 publications

Modern imaging techniques in intra-abdominal hypertension and abdominal compartment syndrome: a bench to bedside overview

Modern imaging techniques in intra-abdominal hypertension and abdominal compartment syndrome: a bench to bedside overview

Stenotic Ischemic Enteritis with Concomitant Hepatic Portal Venous Gas and Pneumatosis Cystoides Intestinalis

Presentation and outcomes among inflammatory bowel disease patients with concurrent pneumatosis intestinalis: a case series and systematic review

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