Reversible pneumatosis cystoides intestinalis after liver transplantation

Telegrafo, Michele; Ianora, Amato Antonio Stabile; Angelelli, Giuseppe; Moschetta, Marco

doi:10.11138/gchir/2017.38.5.239

Cited by 3 publications

(2 citation statements)

References 14 publications

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“…Some predisposing factors may be involved, including scleroderma, systemic lupus erythematosus, granulomatosis with polyangiitis, amyloidosis, myeloma, dermatomyositis, COPD, Crohn's disease, nutritional imbalances, dysbacteriosis, gastrointestinal dysmotility, alpha-glucosidase inhibitor, glucocorticoid, kinin, immunosuppressant inhibitor, bone marrow transplantation, lung transplantation, graft versus host disease, and use of trichloroethylene 1,2,3,7,11,14,23,28,31,32 . Changes in immune function appear to be among the most significant predisposing factors, considering their relation with post-transplant organ status, corticotherapy, rheumatic disease treatment, and chemotherapy 2,33,34 .…”

Section: Discussionmentioning

confidence: 99%

Management of pneumatosis cystoides intestinalis with pneumoperitoneum: 5-years systematic review

Piltcher-da-Silva¹,

Sasaki²,

Gallotti³

et al. 2022

CBR

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Introduction: Pneumatosis cystoides intestinalis (PCI) is a rare condition characterized by gas-filled cysts in the intestinal wall. Although rare, it may also involve other regions, such as the mesentery. PCI is classified as primary or secondary and is associated with multiple predisposing factors. It may be associated with either a benign condition or a potentially fatal condition, such as mesenteric ischemia. The objective of this study was to review the medical literature on the rare benign presentations of PCI, excluding cases associated with intestinal ischemia. Methods:We conducted a systematic literature review according to the PRISMA statement. We searched PubMed and LILACS databases for articles published between January 2015 and December 2020 using the following Medical Subject Headings: "pneumatosis cystoides intestinalis" and "pneumoperitoneum," "pneumatosis intestinalis," and "pneumoperitoneum" or "mesenteric pneumatosis." Results:We included 51 articles comprising 58 patients with PCI and pneumoperitoneum. Most patients were men, and mean patient age was 64.9 years. We identified an idiopathic etiology in 29.31% of cases, and the most common predisposing factor was immune dysfunction (29.31%). A total of 24.13% of patients were asymptomatic. The most commons symptoms were abdominal pain (43.10%), nausea and vomiting (41.37%), and abdominal distention (37.93%). Diagnostic surgery was conducted in 26 patients (44.82%). Only 1 patient underwent surgical treatment.Conclusions: PCI is a clinical condition that may have a benign etiology and not require surgery. Treatment of the benign etiology is conservative. Thus, life-threatening conditions should be excluded in all cases.

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Section: Discussionmentioning

confidence: 99%

Management of pneumatosis cystoides intestinalis with pneumoperitoneum: 5-years systematic review

Piltcher-da-Silva¹,

Sasaki²,

Gallotti³

et al. 2022

CBR

View full text Add to dashboard Cite

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“…Other conditions are associated with iatrogenic factors during colonic and gastric endoscopic procedures [10][11][12] even in children [13], or when a cardiac defibrillator is implanted 14]. Infrequently, HPVG can be due to noninvasive positive pressure ventilation (NIPPV) [15]; it can appear after an allogeneic hematopoietic stem cell transplantation [16,17], or can be a consequence of another rare clinical condition such as pneumatosis cystoides intestinalis [18][19][20][21].…”

Section: Discussionmentioning

confidence: 99%

Gas in the Portal Vein: An Emergency or Just Hot Air?

et al. 2021

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We report the case of a 87-year-old woman admitted to our Emergency Department for mild abdominal pain associated with vomiting. An abdominal X-ray showed gas present in the portal venules of the left hepatic lobe, a finding associated with numerous surgical and medical conditions. The patient was successfully managed with conservative treatment. Isolated intrahepatic gas is a rare radiologic finding; emergency surgery should be performed only when there are signs of associated acute intestinal infarction. KeywordsHepatic portal venous gas (HPVG) • Intrahepatic pneumatosis • Emergency surgery • Intestinal ischemia • Superior mesenteric artery embolism Abbreviations WBC White blood cell Hgb Haemoglobin CRP C-reactive protein HPVG Hepatic portal venous gas AMI Acute mesenteric ischemia ED Emergency Department Case Report and EvolutionA 87-year-old woman was admitted to the ED in "Ospedale Civile Umberto I" in Lugo (Ravenna) for a single vomiting episode associated with mild abdominal pain, without fever or diarrhea. Despite her age, the patient was autonomous in her daily activities; her primary medical comorbidity was chronic atrial fibrillation treated with oral anticoagulants. On initial presentation, the patient appeared in minimal distress; abdominal examination was unremarkable. Laboratory tests showed normal WBC count and Hgb with mildly increased CRP (34 mg/dL; N.V. ≤ 10 mg/dL). An abdominal X-ray showed gas present in the portal venules of the left hepatic lobe (Fig. 1), confirmed by CT scan (Fig. 2) with * N. Zorzetti

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The Challenge of Pneumatosis Intestinalis: A Contemporary Systematic Review

Perrone,

Giuffrida,

Donato

et al. 2024

JPM

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Purpose: Pneumatosis intestinalis is a radiological finding with incompletely understood pathogenesis. To date, there are no protocols to guide surgical intervention. Methods: A systematic review of literature, according to PRISMA criteria, was performed. Medline and PubMed were consulted to identify articles reporting on the items “emergency surgery, pneumatosis coli, and pneumatosis intestinalis” from January 2010 up to March 2022. This study has not been registered in relevant databases. Results: A total of 1673 patients were included. The average age was 67.1 ± 17.6 years. The etiology was unknown in 802 (47.9%) patients. Hemodynamic instability (246/1673–14.7% of the patients) was associated with bowel ischemia, necrosis, or perforation (p = 0.019). Conservative management was performed in 824 (49.2%) patients. Surgery was performed 619 (36.9%) times, especially in unstable patients with bowel ischemia signs, lactate levels greater than 2 mmol/L, and PVG (p = 0.0026). In 155 cases, surgery was performed without pathological findings. Conclusions: Many variables should be considered in the approach to patients with pneumatosis intestinalis. The challenge facing the surgeons is in truly identifying those who really would benefit and need surgical intervention. The watch and wait policy as a first step seems reasonable, reserving surgery only for patients who are unstable or with high suspicion of bowel ischemia, necrosis, or perforation.

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Reversible pneumatosis cystoides intestinalis after liver transplantation

Abstract: SUMMARY: Reversible pneumatosis cystoides intestinalis after liver transplantation.

Cited by 3 publications

References 14 publications

Management of pneumatosis cystoides intestinalis with pneumoperitoneum: 5-years systematic review

Management of pneumatosis cystoides intestinalis with pneumoperitoneum: 5-years systematic review

Gas in the Portal Vein: An Emergency or Just Hot Air?

The Challenge of Pneumatosis Intestinalis: A Contemporary Systematic Review

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