Pneumatosis intestinalis and hepatic portal venous gas caused by enteral feeding after a heart valve surgery

Fukunaga, Naoto; Yoshida, Shosuke; Shimoji, Akio; Maeda, Toshi; Mori, Otohime; Yoshizawa, Kosuke; Okada, Takamitsu; Tamura, Nobushige

doi:10.1016/j.jccase.2022.08.007

Cited by 2 publications

(1 citation statement)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Ischemic bowel walls are more susceptible to penetration and proliferation of bacteria and gasses from the gut, which may contribute to the development of PI. Thirdly, feeding after SGT placement could increase the demand for blood supply, especially in a setting of poor intestinal perfusion [ 11 ]. This can result in ischemic bowel and PI particularly after prolonged total parenteral nutrition use.…”

Section: Discussionmentioning

confidence: 99%

Pneumatosis Intestinalis Following Surgical Gastrostomy Tube Placement in a Patient With Glottic Squamous Cell Carcinoma: A Case Report

Zolotov,

Quintanilla,

Ahmed

et al. 2024

Cureus

View full text Add to dashboard Cite

Pneumatosis intestinalis (PI) is a rare medical and post-surgical sequela of multiple different etiologies which can be either benign or life-threatening. Various mechanisms have been proposed to explain the occurrence of PI; however, the pathophysiology is dependent on the suspected cause. The condition is largely categorized into two broad groups: idiopathic PI, which remains relatively uncommon, and secondary PI. The latter often surfaces as a result of a wide array of both gastrointestinal and nongastrointestinal illnesses. These encompass vascular compromise, bowel mucosal disruption, gastrointestinal dysmotility, as well as infectious and immunological etiologies. Management ranges from conservative medical strategies to emergent surgical intervention.We present the first case to our knowledge of spontaneous PI developing within five days of a surgical gastrostomy tube (SGT) placement in a 79-year-old female with glottic squamous cell carcinoma which unfortunately proved fatal. The purpose of this case report is to highlight a rare fatal complication of a common surgical procedure and the necessity of initiating interdisciplinary management quickly to determine the best treatment course.

show abstract

Section: Discussionmentioning

confidence: 99%

Pneumatosis Intestinalis Following Surgical Gastrostomy Tube Placement in a Patient With Glottic Squamous Cell Carcinoma: A Case Report

Zolotov,

Quintanilla,

Ahmed

et al. 2024

Cureus

View full text Add to dashboard Cite

show abstract

The Challenge of Pneumatosis Intestinalis: A Contemporary Systematic Review

Perrone,

Giuffrida,

Donato

et al. 2024

JPM

View full text Add to dashboard Cite

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.

show abstract

Pneumatosis intestinalis and hepatic portal venous gas caused by enteral feeding after a heart valve surgery

Cited by 2 publications

References 8 publications

Pneumatosis Intestinalis Following Surgical Gastrostomy Tube Placement in a Patient With Glottic Squamous Cell Carcinoma: A Case Report

Pneumatosis Intestinalis Following Surgical Gastrostomy Tube Placement in a Patient With Glottic Squamous Cell Carcinoma: A Case Report

The Challenge of Pneumatosis Intestinalis: A Contemporary Systematic Review

Contact Info

Product

Resources

About