Letter to the editor: Pneumatosis in bowel ischemia: time to change the optics to improve patient care

Calame, Paul; Delabrousse, Éric; Ronot, Maxime

doi:10.1186/s13244-022-01165-z

Cited by 8 publications

(6 citation statements)

References 7 publications

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“… Calame et al (2021) identified that the absence of bowel enhancement and bowel thinning was associated with ITN in the context of NOMI. Therefore, an isolated pneumatosis was not considered to be a sign of necrosis in a recent study ( Calame, Delabrousse & Ronot, 2022 ).…”

Section: Survey Methodologymentioning

confidence: 99%

Advances in the diagnosis of non-occlusive mesenteric ischemia and challenges in intra-abdominal sepsis patients: a narrative review

Zhou¹,

Liu²,

Shou³

et al. 2023

PeerJ

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Non-occlusive mesenteric ischemia (NOMI) is a type of acute mesenteric ischemia (AMI) with a high mortality rate mainly because of a delayed or misdiagnosis. Intra-abdominal sepsis is one of the risk factors for developing NOMI, and its presence makes early diagnosis much more difficult. An increase in routine abdominal surgeries carries a corresponding risk of abdominal infection, which is a complication that should not be overlooked. It is critical that physicians are aware of the possibility for intestinal necrosis in abdominal sepsis patients due to the poor survival rate of NOMI. This review aims to summarize advances in the diagnosis of NOMI, and focuses on the diagnostic challenges of mesenteric ischemia in patients with intra-abdominal sepsis.

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Section: Survey Methodologymentioning

confidence: 99%

Advances in the diagnosis of non-occlusive mesenteric ischemia and challenges in intra-abdominal sepsis patients: a narrative review

Zhou¹,

Liu²,

Shou³

et al. 2023

PeerJ

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“…En la TC, el PA o gas en el sistema porta se define como hipo densidades lineales ramificadas en la periferia del parénquima hepático (ver figura 3B) (2,16). La neumatosis intestinal asociada a la PA ha sido considerada un signo de enfermedad avanzada que usualmente indican lesión irreversible y necrosis transmural (21).…”

Section: Tomografía Computarizada De Abdomenunclassified

Neumatosis intestinal en el adulto: un signo radiológico

Clayton

Jarquín²,

Víquez³

2023

Rev.méd.sinerg.

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La neumatosis intestinal es definida como la presencia de aire dentro de la pared intestinal. Este es un signo radiológico en vez de un cuadro clínico. La neumatosis tiene un largo historial médico, su detención ha sido favorecida ampliamente por el uso de la tomografía computarizada a lo largo de las últimas décadas. Se le halla con mayor frecuencia en el intestino delgado, y raramente es de localización extra intestinal. Se le estima una prevalencia de 0.03%, y es más comúnmente visto entre la edad de los 40 y 50 años. La neumatosis intestinal puede ser clasificada como primaria y secundaria. La forma primaria consiste en una infiltración de gas idiopática en la pared intestinal que asemeja un racimo de uvas, mientras que la forma secundaria es más frecuente y suele estar asociada a un amplio rango de condiciones patológicas como la enfermedad intestinal inflamatoria, malignidades, quimioterapia, estados de inmunodeficiencia o iatrogenia médica. Pero principalmente es un signo que se ha relacionado a isquemia y necrosis intestinal, y que ha sido considerada una emergencia médica, especialmente sí se relaciona con portograma aéreo. En la forma secundaria de neumatosis intestinal, el patrón radiológico es más variable. Esta es mejor detectada y evaluada con la tomografía computarizada, la cual es la prueba de elección para detectar neumatosis intestinal y debe ser utilizada en adultos en cualquier caso en el cual la radiografía convencional o ecografía aumenten su sospecha diagnóstica. El objetivo principal de este artículo es determinar la utilidad de la neumatosis intestinal como signo radiológico, con particular atención a su fisiopatología, clasificación y diagnóstico radiológico.

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“…Davarnapah and Calame proposed staging of AMI based on computed tomography findings [24 ▪▪ ,25]. Importantly, in the early stages of AMI, the bowel wall thickening occurs due to edema and intramural hemorrhage, whereas thinning of the bowel wall is a late sign.…”

Section: Diagnosismentioning

confidence: 99%

“…Availability of CTA in the same patient before the acute event may be helpful to compare the premorbid state of the vessels [43]. Some differences in imaging diagnostics related to assessment of the intestine have been recently nicely visualized in a recent review by Davarnapah and a letter by Calame [24 ▪▪ ,25].…”

Section: Specific Conditionsmentioning

confidence: 99%

Acute mesenteric ischaemia

Blaser

Forbes

Björck

2022

Current Opinion in Critical Care

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Purpose of reviewTo summarize the recent evidence on acute mesenteric ischaemia (AMI).Recent findingsThe overall incidence of AMI is below 10/100 000 person years but increases exponentially with age. The overall mortality of AMI remains high, exceeding 50%, despite continuing progress and increasing availability of imaging and endovascular interventions. However, patients with (early) revascularization have significantly better outcomes. The majority of patients surviving the acute event are still alive at 1 year, but evidence on quality of life is scarce.Clinical suspicion of AMI is the key to timely diagnosis, with biphasic computed tomography-angiography the diagnostic method of choice. Currently, no biomarker has sufficient specificity to diagnose AMI.SummaryImproved awareness and knowledge of AMI are needed to raise the suspicion of AMI in relevant patients and thereby to achieve better outcomes.

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Letter to the editor: Pneumatosis in bowel ischemia: time to change the optics to improve patient care

Cited by 8 publications

References 7 publications

Advances in the diagnosis of non-occlusive mesenteric ischemia and challenges in intra-abdominal sepsis patients: a narrative review

Advances in the diagnosis of non-occlusive mesenteric ischemia and challenges in intra-abdominal sepsis patients: a narrative review

Neumatosis intestinal en el adulto: un signo radiológico

Acute mesenteric ischaemia

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