Benign pneumatosis intestinalis with pneumoperitoneum and typhlitis: side-effects of drug or disease induced immunosuppression

Wright, Naomi Jane; Wiggins, Tom; Stubbs, Benjamin; Engledow, Alec

doi:10.1136/bcr.07.2011.4518

Cited by 8 publications

(3 citation statements)

References 3 publications

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“… 16 PI can be a primary condition (idiopathic) or, more frequently, a secondary manifestation of several pathological phenomena, such as chronic bowel ischemia, obstructive and necrotic GI diseases, systemic autoimmune diseases and iatrogenic causes. 17 …”

Section: Introductionmentioning

confidence: 99%

Imaging of abdominal complications of COVID-19 infection

et al. 2021

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Coronavirus disease 2019 (COVID-19) is a respiratory syndrome caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) first described in Wuhan, Hubei Province, China in the last months of 2019 and then declared as a pandemic. Typical symptoms are represented by fever, cough, dyspnea and fatigue, but SARS-CoV-2 infection can also cause gastrointestinal symptoms (vomiting, diarrhoea, abdominal pain, loss of appetite) or be totally asymptomatic. As reported in literature, many patients with COVID-19 pneumonia had a secondary abdominal involvement (bowel, pancreas, gallbladder, spleen, liver, kidneys), confirmed by laboratory tests and also by radiological features. Usually the diagnosis of COVID-19 is suspected and then confirmed by real-time reverse-transcription-polymerase chain reaction (RT-PCR), after the examination of the lung bases of patients, admitted to the emergency department with abdominal symptoms and signs, who underwent abdominal-CT. The aim of this review is to describe the typical and atypical abdominal imaging findings in patients with SARS-CoV-2 infection reported since now in literature.

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Section: Introductionmentioning

confidence: 99%

Imaging of abdominal complications of COVID-19 infection

et al. 2021

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“…The mortality rates of PI are reported 65%-86% in previous studies when accompanied by portal venous gas (PVG) [11][12][13][14] . However, recently numerous non-ischemic causes of PI have been described because of the improved sensitivity in detection of PI by computed tomography (CT): non-ischemic causes of PI include inflammatory bowel disease, intestinal dilatation, connective tissue disease, organ transplantation or post-operative change, immune-deficiency status, and chemotherapy [15][16][17][18][19] . PI induced by these non-ischemic causes commonly show a benign clinical course and require conservative management rather than surgery.…”

Section: Introductionmentioning

confidence: 99%

Benign versus life-threatening causes of pneumatosis intestinalis: differentiating CT features

Hong

Hwang

et al. 2018

Rev. Assoc. Med. Bras.

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SUMMARY OBJECTIVE: To assess the diagnostic performance of CT findings in differentiating causes of pneumatosis intestinalis (PI), including benign and life-threatening causes. METHODS: All CT reports containing the word “pneumatosis” were queried from June 1st, 2006 to May 31st, 2015. A total of 42 patients with PI were enrolled (mean age, 63.4 years; 23 males and 19 females) and divided into two groups on based on electronic medical records: a benign group (n=24) and a life-threatening group (n=18). Two radiologists reviewed CT images and evaluated CT findings including bowel distension, the pattern of bowel wall enhancement, bowel wall defect, portal venous gas (PVG), mesenteric venous gas (MVG), extraluminal free air, and ascites. RESULTS: CT findings including bowel distension, decreased bowel wall enhancement, PVG, and ascites were more commonly identified in the life-threatening group (all p<0.05). All cases with PVG were included in the life-threatening group (8/18 patients, 44.4%). Bowel wall defect, extraluminal free air, and mesenteric venous gas showed no statistical significance between both groups. CONCLUSION: PI and concurrent PVG, bowel distension, decreased bowel wall enhancement, or ascites were significantly associated with life-threatening causes and unfavorable prognosis. Thus, evaluating ancillary CT features when we encountered PI would help us characterize the causes of PI and determine the appropriate treatment option.

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“…Pneumoperitoneum and pneumatosis cystoides intestinalis can develop after chemotherapy which are relatively rare and in most instances may have a benign self-limiting course but they may become symptomatic and require further intervention as demonstrated by our case. 1 Learning points ▸ Chemotherapy-induced pneumatosis cystoides intestinalis (PCI; gas-filled cysts of the submucosa or subserosa of the bowel that can lead to pneumoperitoneum) is a relatively rare and mostly self-limiting condition. However, pneumoperitoneum in a child with lymphoma treated with chemotherapy is an ominous sign suggestive of gastrointestinal perforation.…”

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confidence: 99%