Management and outcome of pneumatosis intestinalis

Medical management of pneumatosis intestinalis in patients undergoing allogeneic blood and marrow transplantation

“…In a recent series an overall mortality of 22% was observed. 21 This conservative approach to PI management, consisting of non surgical management initially compared favorably with historical mortality rates of 35-75% when many cases were managed with a surgery. [22][23][24] The majority of our patients died of GI GvHD or other GI complications suggesting that PI represents a poor prognostic factor.…”

Portal pneumatosis: Sign of alert or casual discovery?

“…In view of the cases presented, we confirm the presence of portal pneumatosis in situations outside the intestinal ischemia, which presented good prognosis. Likewise, we consider justified the laparotomy in the second patient, since, as several authors maintain (9,10), it is essential, at the slightest suspicion, to rule out serious clinical processes.…”

Spontaneous complete resolution of pneumomediastinum and pneumatosis intestinalis caused by acute GVHD

“…Clinical course varies: most PI patients without a sign of surgical acute abdomen will improve with aggressive supportive therapy, including bowel rest and antibiotics (in addition to GVHD therapy). However, this can be a life-threatening complication leading to bacterial peritonitis or severe sepsis in approximately 20% of all patients with PI regardless of its etiology [4,5]. A higher mean APACHE II score, older age, and sepsis are associated with a higher mortality rate in patients with PI [4,5].…”

“…However, this can be a life-threatening complication leading to bacterial peritonitis or severe sepsis in approximately 20% of all patients with PI regardless of its etiology [4,5]. A higher mean APACHE II score, older age, and sepsis are associated with a higher mortality rate in patients with PI [4,5]. Surgical treatment-it was used more commonly in the past decades-can be associated with high mortality and morbidity [4,6].…”

“…A higher mean APACHE II score, older age, and sepsis are associated with a higher mortality rate in patients with PI [4,5]. Surgical treatment-it was used more commonly in the past decades-can be associated with high mortality and morbidity [4,6]. CT scan findings can be useful to differ severe, clinically worrisome cases from benign PI (e.g., mesenteric stranding, bowel wall thickening, and ascites, and diffuse PI) [7].…”