Gastric Pneumatosis in a Premature Neonate

Ting, Yuk Joseph; Chan, Kok-Lung; Wong, Siu-Chun; Chim, Stephen S.C.; Wong, K K

doi:10.1055/s-0030-1271218

Cited by 11 publications

(10 citation statements)

References 24 publications

(26 reference statements)

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“…Increase in intragastric pressure and dilatation of the stomach has been reported, after positive pressure ventilation without tracheal intubation, possibly due to high cricopharyngeal pressures. The rise of intragastric pressure by NIMV in a damaged gastric mucosa after ibuprofen use can cause submucosal dissection of air as noted in our case 1. Ibuprofen is a well-recognised drug that causes gastric and intestinal mucosal injury.…”

Section: Discussionsupporting

confidence: 53%

“…Cyanotic heart disease has been linked to GP in a neonate with hypoplastic left heart syndrome by Krueger et al ,17 non-invasive ventilation such as NIMV is one of the causes of gastric emphysema, especially in face of ischaemic mucosa. Ting et al reported a case of gastric pneumatosis associated with the use of indomethacin in a preterm neonate while on synchronised NIMV 1. Increase in intragastric pressure and dilatation of the stomach has been reported, after positive pressure ventilation without tracheal intubation, possibly due to high cricopharyngeal pressures.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Pneumatosis intestinalis in a preterm infant: should we treat all intestinal pneumatosis as necrotising enterocolitis?

et al. 2018

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Gastric pneumatosisis a very rare site of pneumatosis intestinalis (PI), and we report this finding in a preterm female infant with cyanotic congenital heart disease. The infant was stable initially on nasal intermittent mandatory ventilation; however, torrential pulmonary flow through a large patent ductus arteriosus prompted closure using oral ibuprofen. After an episode of haematochezia, she developed PI, affecting mainly the gastric wall and small intestine with portal venous gas. Her bowel movements were regular, with no abdominal distension or significant gastric aspirates. She was haemodynamically stable with negative infective markers. Management consisted of endotracheal intubation and ventilation, gastric decompression and broad-spectrum antibiotics. Both the gastric and intestinal pneumatosis resolved within 24 hours and she made an uneventful recovery. If PI is not due to necrotising enterocolitis, enteral nutrition can be initiated early and prolonged course of broad-spectrum antibiotics could have been avoided.

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Pneumatosis intestinalis in a preterm infant: should we treat all intestinal pneumatosis as necrotising enterocolitis?

et al. 2018

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“…The authors postulated that there was a mild damage in the gastric mucosa, due to the placement of the feeding tube or the use of indomethacin or both together. They believed that noninvasive ventilation increased the intragastric pressure that resulted in the submucosal dissection of air followed by the development of gastric pneumatosis [7]. In our patient, the exact cause of gastric pneumatosis remains unclear.…”

Section: Clinical Imagesmentioning

confidence: 73%

Gastric Pneumatosis in a Premature Infant with Necrotizing Enterocolitis

Al‐Alaiyan¹,

Al-Hazzani²

2017

JPNC

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“…Amongst the several postulated theories for the development of gastric emphysema in infancy secondary to obstruction, mucosal damage due to mechanical pressure developed in the distal obstruction is at the forefront. A tear in the mucosa is thought to be the cause for air tracking in the submucosa leading to emphysema [10,15].…”

Section: Discussionmentioning

confidence: 99%

Gastroduodenal Emphysema with Portal Venous Air due to Congenital Duodenal Web in a Child: A Case Report and Review of Literature

Wettasinghe¹,

Rosairo

Kiriwattuduwa³

et al. 2020

Case Reports in Pediatrics

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Congenital duodenal web causing proximal duodenal obstruction leading to gastroduodenal emphysema is a very rare presentation in infancy. Due to persistent  peristalsis against the duodenal membrane, there is progressive stretching of the duodenal web leading to windsock deformity. We describe a rare case of a child with gastroduodenal emphysema and portal venous air due to duodenal obstruction secondary to a duodenal web. An eighteen-month-old male child, who was under investigation for failure to thrive, presented with a history of persistent projectile vomiting and progressive abdominal distension for two days. The abdominal ultrasound scan revealed air within the portal vein and in the wall of the stomach. Plain X-ray abdomen confirmed the presence of gas in the gastric wall and in the proximal duodenal wall. Upper gastrointestinal contrast study revealed complete obstruction at the second part of the duodenum. The child underwent emergency laparotomy, which revealed a duodenal web as the cause of the duodenal obstruction. During the surgery, windsock deformity was noted. This case illustrates that although rare, proximal duodenal obstruction due to duodenal web may present in early childhood and that alarming imaging features such as gastric emphysema and portal venous air could be associated with benign conditions.

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Gastric Pneumatosis in a Premature Neonate

Cited by 11 publications

References 24 publications

Pneumatosis intestinalis in a preterm infant: should we treat all intestinal pneumatosis as necrotising enterocolitis?

Pneumatosis intestinalis in a preterm infant: should we treat all intestinal pneumatosis as necrotising enterocolitis?

Gastric Pneumatosis in a Premature Infant with Necrotizing Enterocolitis

Gastroduodenal Emphysema with Portal Venous Air due to Congenital Duodenal Web in a Child: A Case Report and Review of Literature

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