Pneumatosis intestinalis in oncologic patients: when should the radiologist not be afraid?

Sassi, Claudia; Pasquali, Milena; Facchini, Giancarlo; Bazzocchi, Alberto; Battista, Giuseppe

doi:10.1259/bjrcr.20160017

Cited by 9 publications

(12 citation statements)

References 16 publications

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“…Such cases can be resolved with supportive care alone and close observation. 8 The most common cause of nonsurgical pneumoperitoneum is PI. 9,10 When a cyst ruptures, it may result in a pneumoperitoneum with a spectrum of symptoms ranging from asymptomatic to acute abdominal pain.…”

Section: Discussionmentioning

confidence: 99%

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Two case reports of pneumatosis intestinalis in patients with cancer: is surgical management mandatory?

Yeo

Kim

2021

Clin Exp Emerg Med

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Pneumatosis intestinalis (PI) can be classified into two groups. Primary PI is idiopathic, and patients can recover spontaneously. In contrast, secondary PI is considered fatal due to the high mortality rate associated with mesenteric ischemia. Herein, we describe two patients with PI and concurrent pneumoperitoneum. Both patients were receiving targeted anticancer therapy, yet neither developed abdominal pain nor fatal symptoms. One of the patients underwent surgery, while the other was managed conservatively. Even though there were no complications, the patient who underwent surgery was hospitalized for 34 days, whereas the one who was managed conservatively was hospitalized for only five days. Usually, patients with cancer receiving chemotherapy are immunosuppressed and susceptible to infections. Therefore, based on the patients’ clinical features, surgical management of patients with cancer who develop PI after receiving anticancer chemotherapy should be done prudently.

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Section: Discussionmentioning

confidence: 99%

“…was found, and all the cases were benign. Such cases can be resolved with supportive care alone and close observation [ 8 ]. The most common cause of nonsurgical pneumoperitoneum is PI [ 9 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

Two case reports of pneumatosis intestinalis in patients with cancer: is surgical management mandatory?

Yeo

Kim

2021

Clin Exp Emerg Med

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“…It may be that transmural intestinal necrosis (due to vascular ischaemia) and adverse tissue effects of long-term corticosteriod exposure (for COPD) acted in concert to produce widespread PI. 7 – 9 …”

Section: Discussionmentioning

confidence: 99%

“…Prolonged steroid therapy is known to deplete intestinal lymphoid populations, thus impairing gastrointestinal defences, reducing peristalsis and compromising the integrity of the intestinal wall. 9 , 10 …”

Section: Discussionmentioning

confidence: 99%

Oesophageal pneumatosis in a case of bowel ischaemia

Pasquali

Leonardo²,

Morsiani³

et al. 2017

BJR|case reports

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Pneumatosis intestinalis (PI) is a condition in which cystic collections of gas develop within the gastrointestinal wall, forming submucosal or subserosal “bubbles”. The radiologic manifestations are often dramatic and most notably are associated with life-threatening bowel ischaemia. PI may occur as a primary type but is usually secondary in nature, attributable to a wide spectrum of causes (benign and fulminant), ranging from immunosuppression to bowel infarction. Herein, we report a case of massive and extensive PI in a patient with small bowel ischaemia, having both benign and serious clinical origins.

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“…PI is defined as the presence of gas or air in the submucosal or subserosal space of the intestinal wall. It is a radiological finding rather than a clinical diagnosis [45]. PI is simply categorized as benign PI and secondary PI (most commonly bowel ischemia; Fig.…”

Section: Pneumatosis Intestinalis (Pi)mentioning

confidence: 99%

Drug-induced bowel complications and toxicities: imaging findings and pearls

Srisajjakul

Prapaisilp

Bangchokdee³

2022

Abdom Radiol

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The use of diverse types of drugs can result in a variety of acute and chronic complications that affect almost any organ. The bowel is one of the organs impacted by the side effects of medications. Imaging frequently plays a crucial role in the detection and characterization of complications occurring in the bowel. They include pseudomembranous colitis or antibiotic-associated colitis; angioedema induced by angiotensin-converting enzyme inhibitors; nonsteroidal anti-inflammatory drug-induced enteropathy; cocaine toxicity; clozapine-induced hypomobility; and bowel toxicity induced by chemotherapeutic agents. It is imperative that radiologists are fully aware of these complications and toxicities as well as the relevant findings. In this way, proper treatment can be implemented immediately. The treatment will involve discontinuation of a drug or a change in regimen.

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Pneumatosis intestinalis in oncologic patients: when should the radiologist not be afraid?

Cited by 9 publications

References 16 publications

Two case reports of pneumatosis intestinalis in patients with cancer: is surgical management mandatory?

Two case reports of pneumatosis intestinalis in patients with cancer: is surgical management mandatory?

Oesophageal pneumatosis in a case of bowel ischaemia

Drug-induced bowel complications and toxicities: imaging findings and pearls

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