Gastric Pneumatosis from Isolated Gastric Calciphylaxis

Mulgund, Aditi; Razeghi, Sanam; Poreddy, Sampath

doi:10.14309/crj.2017.91

Cited by 3 publications

(1 citation statement)

References 6 publications

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“…Up to 20 different causes of GP have been reported in the literature such as perforated ulcer, nasogastric tube placement, caustic ingestion, increased intraluminal pressure, blunt trauma. Causes not related to the stomach have also been described such as superior mesenteric artery syndrome, chemotherapy, cholangiocarcinoma, biliary stent-related perforation, gangrenous cholecystis, appendicitis, calciphylaxis [3][4][5]. An explanation could be that gas travels to the stomach from other areas along the alimentary tract wall.…”

Section: Introduction Backgroundmentioning

confidence: 99%

Gastric Pneumatosis with Portal Venous Gas can be Treated Non‐operatively: A Retrospective Multi‐institutional Study

et al. 2022

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Background: Gastric pneumatosis (GP) is a rare radiologic nding with an unpredictable prognosis. The aim of this study was to identify mortality risk factors from patients presenting with GP on computed tomography (CT), and to develop a model which would allow us to predict which patients would bene t most from operative management. Methods: Between 2010 and 2020, all CT-scan reports in 4 tertiary centers were searched for the following terms: "gastric pneumatosis", "intramural gastric air" or "emphysematous gastritis". The retrieved CT scans were reviewed by a senior surgeon and a senior radiologist. Relevant clinical and laboratory data for these patients were extracted from the institutions' medical records.Results: Among 58 patients with GP portal venous gas and bowel ischemia were present on CT scan in 52 (90%) and 17 patients (29%), respectively. The 30-day mortality rate was 31%. Univariate analysis identi ed the following variables as predictive of mortality at the time of the diagnosis of GP: abdominal guarding, hemodynamic instability, arterial lactate level >2mmol/l, and absence of gastric dilatation.Multivariable analysis identi ed the following variables as independent predictors of mortality: arterial lactate level (OR: 1.39, 95% CI: 1.07 -1.79) and absence of gastric dilatation (OR: 0.07, 95% CI: 0.01 -0.79). None of the patients presenting with a baseline lactate rate <2 mmol/l died within 30 days following diagnosis, and no more than 17 patients out of 58 had bowel ischemia (29%).Conclusions: GP could be managed non-operatively, even in the presence of portal venous gas. However patients with arterial lactate level>2mmol/l, or absence of gastric dilation should be surgically explored due to a non-negligible risk of mortality.

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Section: Introduction Backgroundmentioning

confidence: 99%

Gastric Pneumatosis with Portal Venous Gas can be Treated Non‐operatively: A Retrospective Multi‐institutional Study

et al. 2022

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Gastric Pneumatosis With Portal Venous Gas Can Be Treated Non-operatively: a Retrospective Multi-institutional Study

Epin¹,

Passot

Christou

et al. 2021

Preprint

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Background: Gastric pneumatosis (GP) is a rare radiologic finding with an unpredictable prognosis. The aim of this study was to identify mortality risk factors from patients presenting with GP on computed tomography (CT), and to develop a model which would allow us to predict which patients would benefit most from operative management.Methods: Between 2010 and 2020, all CT-scan reports in 4 tertiary centers were searched for the following terms: “gastric pneumatosis”, “intramural gastric air” or “emphysematous gastritis”. The retrieved CT scans were reviewed by a senior surgeon and a senior radiologist. Relevant clinical and laboratory data for these patients were extracted from the institutions’ medical records. Results: Among 58 patients with GP portal venous gas and bowel ischemia were present on CT scan in 52 (90%) and 17 patients (29%), respectively. The 30-day mortality rate was 31%. Univariate analysis identified the following variables as predictive of mortality at the time of the diagnosis of GP: abdominal guarding, hemodynamic instability, arterial lactate level >2mmol/l, and absence of gastric dilatation. Multivariable analysis identified the following variables as independent predictors of mortality: arterial lactate level (OR: 1.39, 95% CI: 1.07 - 1.79) and absence of gastric dilatation (OR: 0.07, 95% CI: 0.01 - 0.79). None of the patients presenting with a baseline lactate rate <2 mmol/l died within 30 days following diagnosis, and no more than 17 patients out of 58 had bowel ischemia (29%).Conclusions: GP could be managed non-operatively, even in the presence of portal venous gas. However patients with arterial lactate level>2mmol/l, or absence of gastric dilation should be surgically explored due to a non-negligible risk of mortality.

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A Fatal Case of Systemic Calciphylaxis in the Gastrointestinal Tract: A Case Report and Literature Review

Chinnappan¹,

Aguirre²,

Marcus³

et al. 2023

Cureus

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Calciphylaxis is an infrequent yet lethal disease often associated with end-stage kidney disease (ESKD). The most common sites include proximal and distal extremities and the trunk, with few reported in the penis and very few as gastrointestinal (GI) disease. We report a case of systemic calciphylaxis in a middle-aged male, presenting with a colostomy leak and parastomal abscess. Workup revealed severe calcification of the intestinal arteries and ischemic colon necrosis. The patient underwent colectomy, antibiotic therapy, regular hemodialysis (HD), and sodium thiosulphate infusion with clinical stability. Histopathology of the colon revealed ischemic necrosis and pericolonic vessel calcification suggestive of calciphylaxis. It is an important differential to be considered in patients with risk factors presenting with symptoms of gastrointestinal hemorrhage and necrosis with perforation.

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Gastric Pneumatosis from Isolated Gastric Calciphylaxis

Cited by 3 publications

References 6 publications

Gastric Pneumatosis with Portal Venous Gas can be Treated Non‐operatively: A Retrospective Multi‐institutional Study

Gastric Pneumatosis with Portal Venous Gas can be Treated Non‐operatively: A Retrospective Multi‐institutional Study

Gastric Pneumatosis With Portal Venous Gas Can Be Treated Non-operatively: a Retrospective Multi-institutional Study

A Fatal Case of Systemic Calciphylaxis in the Gastrointestinal Tract: A Case Report and Literature Review

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