Neumatosis intestinal en la enfermedad de Crohn

González-Olivares, C.; Palomera-Rico, Ana; Blanca, Nieves Romera-Pintor; Aldehuelo, Rubén Sánchez; Figueroa-Tubío, Alexandre; Filia, Irene García de la; López-Sanromán, Antonio

doi:10.1016/j.gastrohep.2018.05.007

Cited by 2 publications

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“…However, none of these patterns is pathognomonic of any underlying pathology, and they have not been correlated with its severity or etiology (8). CT also allows to detect findings that may suggest the underlying etiology, as well as potentially worrisome findings ("red flags"), such as thickening of the intestinal wall, decreased uptake of contrast material by the mucosa, dilation of intestinal loops, ascites, or presence of portal gas (2,9) . Our patient's abdominal CT showed thickening of the jejunum and ileum walls and dilation of the loops of the proximal small intestine, so she underwent additional diagnostic studies.…”

Section: Discussionmentioning

confidence: 99%

“…Cases managed with clinical surveillance, antibiotic therapy and hyperbaric oxygen therapy have been described (the increase in blood partial pressure of oxygen increases the gas pressure gradient with respect to the cysts, which release the gases contained within them and are recharged with oxygen, which is subsequently metabolized and leads to resolution). For cases presenting as an acute intra-abdominal catastrophe, surgical treatment should be considered (1)(2)(3)9) . Several authors have attempted to identify ominous indicators that require surgical intervention.…”

Section: Discussionmentioning

confidence: 99%

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Pneumatosis intestinalis as a presentation of Crohn’s disease: a case report

Rubio

Rengifo

Silva

2020

Rev Gastroenterol Peru

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Pneumatosis intestinalis (PI) is defined as presence of gas within the intestinal wall. It is a rare condition, usually associated with a wide variety of pathologies. It requires a special diagnostic approach to determine underlying etiology. We present the case of a 18 year old woman with chronic abdominal pain, who presents with peritoneal signs and pneumoperitoneum. Laparoscopy showed NI. Thereafter, Crohn´s disease was diagnosed by balloon enteroscopy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Pneumatosis intestinalis as a presentation of Crohn’s disease: a case report

Rubio

Rengifo

Silva

2020

Rev Gastroenterol Peru

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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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Neumatosis intestinal en la enfermedad de Crohn

Cited by 2 publications

References 5 publications

Pneumatosis intestinalis as a presentation of Crohn’s disease: a case report

Pneumatosis intestinalis as a presentation of Crohn’s disease: a case report

The Challenge of Pneumatosis Intestinalis: A Contemporary Systematic Review

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