Survival from a 75% TBSA thermal injury complicated by bowel ischemia presenting with pneumatosis intestinalis

Abstract

Thermal injury is associated with an increased risk of abdominal complications such as ischemia, infarction and pneumatosis intestinalis (PI). PI is characterized by gas in the intestinal wall and, when diagnosed it can signify the presence of a life-threatening condition. We present a case of a patient who survived 75% total body surface area burns complicated by ischemic bowel that initially presented as extensive PI. This patient was emergently taken to the operating room and underwent a subtotal colectomy and small bowel resection for ischemic bowel. Prompt diagnosis and successful management of the underlying condition ultimately contributed to the patient’s survival. The presence of peritonitis or abdominal distension, portomesenteric venous gas and lactic acidosis should prompt immediate surgical intervention in the post-burn period.

Letter to the Editor on “Experience in the Management of Burn Injuries During Pregnancy in a Burn Unit”

“…One of these was an emergent Caesarian section on the day of admission for significant physiologic compromise; her history has been previously presented. 3 The other three delivered between 24 and 72 hours after admission.…”