Hyperbaric oxygen treatment for intractable diarrhea caused by pneumatosis coli

Lustberg, Alexander; Fantry, George T.; Cotto-Cumba, Cynthia; Drachenberg, Cinthia B.; Darwin, Peter

doi:10.1067/mge.2002.129533

Cited by 3 publications

(4 citation statements)

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“…Frossard et al 21 administered 17 treatments to a patient with non-scleroderma PI, including multiple Comex 30 hyperbaric treatments (50:50 heliox gas mixture) typically reserved for severe decompression illness 22. There is also a case report of pneumatosis coli and diarrhoea resolving after an 8-week tapering regimen of HBO 2 therapy 23. Ongoing resolution of bowel wall gas cysts in PI after HBO 2 therapy is documented for 6 months to 9 years after HBO 2 , although immediate recurrence is also documented 21 24.…”

Section: Discussionmentioning

confidence: 99%

Successful treatment of pneumatosis intestinalis with associated pneumoperitoneum and ileus with hyperbaric oxygen therapy

et al. 2017

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Pneumatosis intestinalis (PI), or the presence of air in the bowel wall, is a rare disorder that is associated with a variety of underlying diseases, including connective tissue disorders. PI presents on a spectrum from asymptomatic to bowel obstruction and acute abdomen. In general, treatment of PI consists of treating the underlying disease. Both normobaric and hyperbaric oxygen have been used to treat PI directly. Here we report a symptomatic scleroderma-related case of PI that responded clinically to hyperbaric oxygen therapy. This report adds to a growing body of literature supporting a role for hyperbaric oxygen therapy in symptomatic PI.

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Section: Discussionmentioning

confidence: 99%

Successful treatment of pneumatosis intestinalis with associated pneumoperitoneum and ileus with hyperbaric oxygen therapy

et al. 2017

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“…Evaluation with endoscopic ultrasonography can be helpful in diagnosing PI endoscopically. [20][21][22] Associated Disease and Causes There are multiple diseases associated with PI (Table). 3,4,7,9,15,18, The most common causes are related to gastrointestinal diseases, pulmonary diseases, rheumatologic diseases, infectious diseases, medication-related diseases, and traumatic diseases secondary to endoscopic or surgical procedures.…”

Section: Clinical Symptomsmentioning

confidence: 99%

“…In addition, increased tissue oxygenation from HBO may facilitate phagocytic activity and directly target the gas-producing organisms via anaerobic impairment. 20,22,74 A number of case reports have been published supporting the efficacy of HBO. Shimada et al 22 reviewed 15 cases of PI treated with HBO in the Japanese literature.…”

Section: Surgical Managementmentioning

confidence: 99%

“…In review of the literature, there are 35 illustrative cases from the literature in which HBO therapy was successfully used in patients ranging in age from 10 months to 86 years. 12,18,20,21,[24][25][26][27][28][29][31][32][33]73,76,[79][80][81][82][83][84][85] There were no reported complications. Initial resolution or improvement in symptoms was achieved in 31 of 35 (89%) patients.…”

Section: Surgical Managementmentioning

confidence: 99%

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Pneumatosis Intestinalis With a Focus on Hyperbaric Oxygen Therapy

Feuerstein

White

Berzin

2014

Mayo Clinic Proceedings

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Pneumatosis intestinalis is a rare condition of air in the bowel wall. Pneumatosis intestinalis is most often secondary to another medical condition. The diagnosis is most often made radiologically with a computed tomography scan. The disease severity ranges from benign to life-threatening. Predictors of poor outcomes include pH less than 7.3, bicarbonate level of less than 20 mEq/L, lactate level of more than 2 mmol/L, amylase level of more than 200 U/L, and portal venous gas on imaging. Early recognition of life-threatening signs and symptoms is critical. Treatment options include bowel rest, antibiotics, surgery, and, more recently, the use of hyperbaric oxygen therapy. Hyperbaric oxygen therapy is extremely safe, with no reported complications in the literature when used for pneumatosis intestinalis. When surgery is not emergently needed, symptomatic pneumatosis intestinalis can be safely treated with hyperbaric oxygen with a high likelihood of success without any considerable adverse effects.

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The Role of Hyperbaric Oxygen Therapy in Pneumatosis Cystoides Intestinalis—A Scoping Review

2021

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Pneumatosis cystoides intestinalis (PCI) is characterized by gas-filled cysts within gastrointestinal tract wall from esophagus to rectum, with preferential involvement of large and small intestine. PCI is rare with an estimated incidence of 0.03 to 0–2% in general population. PCI can be distinguished into idiopathic (15%) or secondary (85%) and the clinical picture ranges from completely asymptomatic to life-threatening intraabdominal complications. Although etiology of PCI appears to be multifactorial, the exact pathophysiology is poorly understood and two main theories have been proposed (mechanical and bacterial). Over the last decades, an enormous therapeutic armamentarium was considered in PCI's management, including hyperbaric oxygen therapy (HBOT). Treatment comprises conservative treatment in mild cases to surgery in highly symptomatic and complicated PCI. In the late 70s, HBOT started to be used in selected cases of PCI not responding to conservative measures. Since then, several case reports, case series, and reviews have been published in the literature with variable outcomes. The overall response rate and complete response were 92.1% (n = 82/89) and 65.2% (n = 58/89), respectively, with a median follow-up of 7 months. Furthermore, HBOT is extremely safe, with few reported complications in the literature when used for PCI. Nevertheless, a randomized, controlled, and double-blind clinical trial is unlikely to occur given the rarity of PCI, logistical issues of HBOT, and methodological considerations related to adequate blinding with a sham-controlled group. HBOT in combination with personalized diet and antibiotics may be beneficial for moderate to severe PCI in patients with no indication for emergency exploratory laparotomy. The purpose of this article is to synthesize the existing data, analyse results of previous studies, identify gaps in knowledge, and discuss PCI' management, including the proposal of an algorithm, with a special focus on HBOT.

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Hyperbaric oxygen treatment for intractable diarrhea caused by pneumatosis coli

Cited by 3 publications

References 0 publications

Successful treatment of pneumatosis intestinalis with associated pneumoperitoneum and ileus with hyperbaric oxygen therapy

Successful treatment of pneumatosis intestinalis with associated pneumoperitoneum and ileus with hyperbaric oxygen therapy

Pneumatosis Intestinalis With a Focus on Hyperbaric Oxygen Therapy

The Role of Hyperbaric Oxygen Therapy in Pneumatosis Cystoides Intestinalis—A Scoping Review

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