Large bowel pneumatosis intestinalis: to operate or not to operate?

Gassend, Jean-Loup; Dimitrief, Maria; Roulet, Daniel; Cherbanyk, Floryn

doi:10.1136/bcr-2016-214612

Cited by 3 publications

(1 citation statement)

References 1 publication

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“…In addition to medication-induced pneumatosis, systemic diseases (eg, lupus or acquired immunodeficiency syndrome), inflammatory bowel diseases, and pulmonary diseases (eg, asthma or cystic fibrosis), as well as bone marrow transplant, abdominal, and thoracic organ transplant, can lead to pneumatosis intestinalis. [1][2][3][4][5][6][7] In this case report, we present a patient with recurrent pneumoperitoneum and pneumatosis intestinalis after bilateral lung transplant in which we used a conservative approach involving antibiotic therapy with metronidazole.…”

Section: Introductionmentioning

confidence: 99%

A Case of Recurrent Pneumoperitoneum and Pneumatosis Intestinalis After Bilateral Lung Transplant

Beetz

Kleine²,

Vondran³

et al. 2019

Exp Clin Transplant

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We report a case of a 60-year-old male patient with recurrent episodes of free gas in the peritoneal and the retroperitoneal cavities as well as pneumatosis intestinalis 3 months after bilateral lung transplant. Interestingly, despite staged laparotomy within the scope of the first episode, no cause for free gas could be found. In a second episode of symptomatically pneumatosis, a conservative treatment with metronidazole was performed successfully. Despite several case reports on patients with pneumatosis intestinalis after lung transplant, an effective treatment strategy has not yet been proposed.

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Section: Introductionmentioning

confidence: 99%

A Case of Recurrent Pneumoperitoneum and Pneumatosis Intestinalis After Bilateral Lung Transplant

Beetz

Kleine²,

Vondran³

et al. 2019

Exp Clin Transplant

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Pneumatosis Cystoides Intestinalis: Report of a New Case of a Patient with Artropathy and Asthma

Onorati¹

2017

Arch Clin Gastroenterol

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The Challenge of Pneumatosis Intestinalis: A Contemporary Systematic Review

Perrone,

Giuffrida,

Donato

et al. 2024

JPM

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Purpose: Pneumatosis intestinalis is a radiological finding with incompletely understood pathogenesis. To date, there are no protocols to guide surgical intervention. Methods: A systematic review of literature, according to PRISMA criteria, was performed. Medline and PubMed were consulted to identify articles reporting on the items “emergency surgery, pneumatosis coli, and pneumatosis intestinalis” from January 2010 up to March 2022. This study has not been registered in relevant databases. Results: A total of 1673 patients were included. The average age was 67.1 ± 17.6 years. The etiology was unknown in 802 (47.9%) patients. Hemodynamic instability (246/1673–14.7% of the patients) was associated with bowel ischemia, necrosis, or perforation (p = 0.019). Conservative management was performed in 824 (49.2%) patients. Surgery was performed 619 (36.9%) times, especially in unstable patients with bowel ischemia signs, lactate levels greater than 2 mmol/L, and PVG (p = 0.0026). In 155 cases, surgery was performed without pathological findings. Conclusions: Many variables should be considered in the approach to patients with pneumatosis intestinalis. The challenge facing the surgeons is in truly identifying those who really would benefit and need surgical intervention. The watch and wait policy as a first step seems reasonable, reserving surgery only for patients who are unstable or with high suspicion of bowel ischemia, necrosis, or perforation.

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Large bowel pneumatosis intestinalis: to operate or not to operate?

Cited by 3 publications

References 1 publication

A Case of Recurrent Pneumoperitoneum and Pneumatosis Intestinalis After Bilateral Lung Transplant

A Case of Recurrent Pneumoperitoneum and Pneumatosis Intestinalis After Bilateral Lung Transplant

Pneumatosis Cystoides Intestinalis: Report of a New Case of a Patient with Artropathy and Asthma

The Challenge of Pneumatosis Intestinalis: A Contemporary Systematic Review

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