Response to Octreotide of Intestinal Pseudoobstruction and Pneumatosis Cystoides Intestinalis Associated with Progressive Systemic Sclerosis.

Kobayashi, Toshiyuki; Kobayashi, Mutsuhiro; Naka, Motoji; Nakajima, Kazuo; Momose, Atsushi; Toi, Makoto

doi:10.2169/internalmedicine.32.607

Cited by 28 publications

(12 citation statements)

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“…The possible rationale of oxygen use suggests that increased oxygen content in the gas cysts will raise the diffusion gradient between cysts and venous capillary flow and enhance their absorption 30 . The effectiveness of octreotide was demonstrated in SSc patients with PCI resistant to other treatments (case 3) 7 . In SSc patients with known macrovascular disease, angioplasty and stent insertion failed; PCI resolved only after initiation of broad‐spectrum intravenous antibiotics and parenteral nutrition 5 .…”

Section: Discussionmentioning

confidence: 99%

Pneumatosis cystoides intestinalis in scleroderma‐related conditions

Balbir‐Gurman

Brook

Chermesh

et al. 2012

Internal Medicine Journal

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Section: Discussionmentioning

confidence: 99%

Pneumatosis cystoides intestinalis in scleroderma‐related conditions

Balbir‐Gurman

Brook

Chermesh

et al. 2012

Internal Medicine Journal

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“…We found 110 patients treated conservatively by different modalities; in 98 patients (89%) PI resolved while 11 patients (11%) died. Table 1 summarizes conservative treatment in PI [5, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16]. …”

Section: Discussionmentioning

confidence: 99%

“…Several authors described good response and resolution of pseudoobstruction with the use of octreotide [12, 19, 20, 21]. Kobayashi et al [12] reported a 26-year-old woman with PI who responded poorly to conventional treatment. Subcutaneous administration of octreotide, at a dose of 50 μg/day for 3 weeks, relieved symptoms such as nausea and bloating.…”

Section: Discussionmentioning

confidence: 99%

Pneumatosis Intestinalis: Can We Avoid Surgical Intervention in Nonsurgical Patients?

Al-Talib

Al-Ghtani

Munk

2009

Case Rep Gastroenterol

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Pneumatosis intestinalis (PI) is the presence of gas within the wall of the gastrointestinal tract and represents a tremendous spectrum of conditions and outcomes, ranging from benign diseases to abdominal sepsis and death. It is seen with increased frequency in patients who are immunocompromised because of steroids, chemotherapy, radiation therapy, or AIDS. PI may result from intraluminal bacterial gas entering the bowel wall due to increased mucosal permeability caused by defects in bowel wall lymphoid tissue. We present a case of PI who was treated conservatively and in whom PI resolved completely and we present a literature review of conservative management. It is not difficult to make a precise diagnosis of PI and to prevent unnecessary surgical intervention, especially when PI presents without clinical evidence of peritonitis. Conservative treatment is possible and safe for selected patients. Awareness of these rare causes of PI and close observation of selected patients without peritonitis may prevent unnecessary invasive surgical explorations.

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“…The recurrence rate after all these types of treatment within 18 months is 30-40 percent [8]. Successful treatments with infliximab and octreotide are also reported in patients with connective tissue diseases [64][65].…”

Section: Antibioticsmentioning

confidence: 99%

Pneumatosis cystoides intestinalis

et al. 2011

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La pneumatose kystique est un état gastro-intestinal rare caractérisé par la présence de gaz dans la paroi intestinale, principalement dans celle de l'intestin grêle ou du côlon. Ce phénomène apparaît sous trois formes différentes : 1) la pneumatose kystique primaire ; 2) la forme secondaire qui accompagne un grand nombre de maladies gastrointestinales et systémiques ; 3) la pneumatose compliquant l'ischémie intestinale. La pathogénie n'est pas clairement connue, elle est très probablement multifactorielle ; la surproduction d'hydrogène est la théorie la plus probable expliquant la formation de la PKI. La Pneumatose kystique intestinale (PKI) est fréquemment découverte de manière fortuite au cours d'une coloscopie -la suspicion endoscopique de la PKI, basée sur un collapse au cours de la ponction, peut être soutenue par des prélèvements cytologiques typiques. La tomodensitométrie est la technique de radiodiagnostic la plus sensible qui peut également détecter une maladie sous-jacente. L'oxygénothérapie et les antibiotiques sont essentiels dans la prise en charge conservatrice et doivent être accompagnés d'une thérapie de la maladie sous-jacente. Les candidats à une intervention chirurgicale ou radiointerventionnelle se recrutent principalement dans la troisième forme de PKI, au cours des ischémies mésentériques aiguës. To cite this journal: Acta Endosc. 41 (2011). Mots clés Pneumatose kystique intestinale · Pneumopéritoine · Hydrogène · Ischémie intestinaleAbstract Pneumatosis cystoides is a rare gastrointestinal condition characterised by the presence of gas in the wall of the gastrointestinal tract, predominantly the small and large intestine. This phenomenon occurs in three forms: 1) primary pneumatosis cystoides, 2) a secondary form, which accompanies a wide range of gastrointestinal and systemic diseases, and 3) pneumatosis complicating intestinal ischaemia. The pathogenesis is not clearly known and is most likely multifactorial; hydrogen overproduction represents what is probably the most consistent theory of PCI formation. PCI is often an incidental finding during colonoscopy -endoscopic suspicion on PCI based on collapse during the puncture can be supported by the typical cytological findings. Computerised tomography is the most sensitive radiodiagnostic method, which can also detect possible underlying disease. Oxygen inhalation and antibiotics is the mainstay in conservative therapy, together with therapy of the underlying disease. Candidates for surgical and/or radiological intervention are mainly recruited from the third group of PCI accompanying abdominal catastrophe such as intestinal ischaemia. Pour citer cette revue : Acta Endosc. 41 (2011).

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Response to Octreotide of Intestinal Pseudoobstruction and Pneumatosis Cystoides Intestinalis Associated with Progressive Systemic Sclerosis.

Cited by 28 publications

References 12 publications

Pneumatosis cystoides intestinalis in scleroderma‐related conditions

Pneumatosis cystoides intestinalis in scleroderma‐related conditions

Pneumatosis Intestinalis: Can We Avoid Surgical Intervention in Nonsurgical Patients?

Pneumatosis cystoides intestinalis

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