Pneumoperitoneum, pneumatosis intestinalis and portal venous gas: Rare gastrostomy complications case report

Abstract

Highlights Open gastrostomy lethal complications include intestinal pneumatosis and portal venous gas. Intestinal necrosis, disruption of mucosa, increased permeability of mucosa, and pulmonary disease, can cause complications. There are several theories describing pathophysiology of intestinal pneumatosis. one of them, secondary to surgery or trauma. Medical versus surgical management of the complications depend on the patient’s comorbidities and physician’s consideration.

Pneumatosis Intestinalis Following Surgical Gastrostomy Tube Placement in a Patient With Glottic Squamous Cell Carcinoma: A Case Report

“…A comparable case involved a 19-year-old patient with cerebral palsy who developed severe abdominal pain as a manifestation of PI 10 days after gastrostomy [ 12 ]. This case was elucidated by Perez Rivera et al, who hypothesized an intriguing pathophysiology.…”

Pneumatosis Intestinalis and Hepatic Portal Venous Gas: Watch and Wait or Emergency Surgery? A Case Report and Literature Review

“…PI, HPVG can be iatrogenic especially in conditions of malnutrition [ 16 ]. This condition is associated with a high mortality rate (56–90%) and may require an urgent operative intervention [ 17 ].…”

The characteristics of residual pneumoperitoneum after laparoscopic colorectal surgery

“…Nonsurgical pneumoperitoneum can occur due to thoracic, abdominal, obstetric and gynecologic, and iatrogenic causes 3 . Various cases of iatrogenic pneumoperitoneum have been reported, and residual pneumoperitoneum after surgery occurs due to iatrogenic causes 4–10 . Nonsurgical pneumoperitoneum should be managed with conservative treatment and careful monitoring when the patient does not have clinical signs or symptoms of peritonitis 3,11 .…”

“…3 Various cases of iatrogenic pneumoperitoneum have been reported, and residual pneumoperitoneum after surgery occurs due to iatrogenic causes. [4][5][6][7][8][9][10] Nonsurgical pneumoperitoneum should be managed with conservative treatment and careful monitoring when the patient does not have clinical signs or symptoms of peritonitis. 3,11 Nevertheless, it can be difficult to distinguish between residual pneumoperitoneum and free air caused by anastomotic failure, especially after gastrointestinal surgery, and residual pneumoperitoneum can lead to invasive procedures (eg, exploratory laparotomy) if the patient experiences symptoms.…”