Pneumatosis intestinalis and mesenteric venous gas - A manifestation of bacterascites in a patient with cirrhosis

Yellapu, RK; Rajekar, Harshal; Martin, JD; Td, Schiano

doi:10.4103/0022-3859.74287

Cited by 7 publications

(12 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Prior studies have characterized high levels of hydrogen in patients with PI, with increased breath hydrogen and excreted hydrogen levels following treatment with lactulose . The first theory hypothesizes a mechanical etiology where gas dissects the bowel wall from either the lumen or the serosa due to an increase in pressure . The second theory outlines a bacterial cause where gas‐forming organisms access the bowel wall via compromised mucosa, where they are able to proliferate and produce gas .…”

Section: Discussionmentioning

confidence: 99%

Idiopathic pneumatosis intestinalis secondary to lactulose use in patients with cirrhosis

Varelas

Klinge

Malik

et al. 2019

J of Gastro and Hepatol

View full text Add to dashboard Cite

Background and Aim Few case reports exist that link lactulose use with pneumatosis intestinalis in cirrhotics. This study investigates the relationship between lactulose use and idiopathic pneumatosis intestinalis in a cohort of cirrhotic patients. Methods This case series considers several notable cases of patients with idiopathic pneumatosis intestinalis and concurrent lactulose use. Idiopathic pneumatosis intestinalis was defined as pneumatosis intestinalis with no identifiable etiology. A cohort of 119 patients with cirrhosis and pneumatosis intestinalis were identified in a tertiary care setting, via chart review by a multidisciplinary team. Eleven of these patients were found to have idiopathic pneumatosis intestinalis. Nine of these patients were being treated with lactulose. Results Six out of 9 patients with idiopathic pneumatosis intestinalis that were being treated with lactulose saw resolution of pneumatosis intestinalis following discontinuation of treatment. Conclusions The etiology of idiopathic pneumatosis intestinalis is likely multifactorial, but lactulose might play a preventable role in its formation.

show abstract

Section: Discussionmentioning

confidence: 99%

Idiopathic pneumatosis intestinalis secondary to lactulose use in patients with cirrhosis

Varelas

Klinge

Malik

et al. 2019

J of Gastro and Hepatol

View full text Add to dashboard Cite

show abstract

“…The most accepted theories are the bacterial and the decrease in the mucosa permeability. 4,11 There are three pathologic forms; microvesicular or pseudolipomatosis, cystic and diffuse. 4 Our 3 patients were over the age of 60 and gas-filled cystic lesions were localized in the ileum.…”

Section: Discussionmentioning

confidence: 99%

“… 4,11 There are three pathologic forms; microvesicular or pseudolipomatosis, cystic and diffuse. 4 Our 3 patients were over the age of 60 and gas-filled cystic lesions were localized in the ileum. H. pylori can be considered in etiology of PSI that identified in the biopsy of 3 patients ( Figs.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The appearance of free-air in the abdomen with related pneumatosis cystoides intestinalis: Three case reports and review of the literature

Aziret

Erdem

Ulgen

et al. 2014

International Journal of Surgery Case Reports

View full text Add to dashboard Cite

INTRODUCTIONPneumatosis sistoides intestinalis (PSI) is a rare condition with unknown origin, defined as the appearance of gas-filled cysts in the intestinal wall. It usually occurs due to respiratory infections, tumor or collagen disease, traumas, immunosuppression.PRESENTATION OF CASEThree patients with PSI were examined that followed up and treated in our clinic. The first patient was hospitalized for emergency treatment of previously diagnosed free-air under the diaphragm. He had a defense on physical examination and free-air was detected in X-ray and abdomen CT. We decided to laparatomy and peroperatively, stenotic pylorus with an abnormally increased stomach and gas-filled cysts were seen in the terminal ileum. Antrectomy and gastrojejunostomy with partial ileum and cecum resection and end ileostomy were performed. The second patient underwent laparatomy because of intraperitoneal free-air and acute abdomen. Partial ileum and cecum resection and ileotransversostomy were performed. The third patient with intraperitoneal free-air was treated with antibiotics, oxygen treatment and bowel rest.DISCUSSIONPSI is usually asymptomatic. Plain radiographs, USG, CT, upper gastrointestinal endoscopy, colonoscopy can use for diagnosis. Treatment of PSI depends on the underlying cause; include elemental diet, antibiotics, steroids, hyperbaric oxygen therapy and surgery.CONCLUSIONIn patients with asymptomatic and symptomatic PSI are different treat. Symptomatic PSI can be safely treated antrectomy and gastrojejunostomy with partial ileum and cecum resection.

show abstract

“…The true incidence of PCC in general population remains unknown, but intestinal pneumatosis is found in 0.03-0.2% of autopsies, predominantly in males (3). PCC may be idiopathic (15%) or it accompanies various clinical conditions of digestive system (peptic ulcer, pyloric stenosis, Crohn's disease, appendicitis, necrotizing enterocolitis, bacterascites) or respiratory (chronic obstructive pulmonary disease, cystic fibrosis), autoimmune (dermatomyositis, scleroderma), inflammatory, infectious (Clostridium difficile, HIV) diseases or trauma (4,5). Development of PCC is rarely attributed to pharmacotherapy with different agents, including α-glucosidase inhibitors (6).…”

Section: Discussionmentioning

confidence: 99%

Segmental pneumatosis cystoides coli: Computed tomography-facilitated diagnosis

Ksiądzyna

Peña

2015

Rev Esp Enferm Dig

View full text Add to dashboard Cite

Background: Intestinal pneumatosis is a rare entity of unclear etiopathogenesis characterized by the presence of gaseous cystic or linear collections within the intestinal wall. Intestinal pneumatosis may be primary and idiopathic in origin or, more frequently, it accompanies various clinical conditions. Rarely, the development of intestinal pneumatosis is attributed to the pharmacotherapy with different drugs.Case report: This is a case report of cystic pneumatosis limited to the large intestine with predominant clinical presentation of chronic watery diarrhea in a 64-year-old man suffering from diabetes mellitus treated with metformin and acarbose. The patient had been referred to the outpatient gastroenterology clinic for further investigation of numerous polyp-like lesions found on colonoscopy. There was no history of cigarette smoking, drug abuse or extraintestinal complaints. The patient was in a good general condition and his laboratory tests were normal. No relevant abnormalities were found on chest X-ray, esophagogastroduodenoscopy or abdominal ultrasound, but computed tomography showed intramural gas-filled bubbles in the cecum and splenic flexure without signs of perforation or any other significant pathology in the abdominal cavity. The final diagnosis of pneumatosis cystoides coli (PCC), possibly related to treatment with acarbose, was established. On a follow-up visit after discontinuation of acarbose the patient reported no complaints and remained asymptomatic for the next 12 months.Discussion: To conclude, drug-related PCC should be considered in a differential diagnosis of gastrointestinal symptoms and/or polyp-like lesions disclosed on colonoscopy in diabetic patients treated with acarbose.

show abstract

Pneumatosis intestinalis and mesenteric venous gas - A manifestation of bacterascites in a patient with cirrhosis

Cited by 7 publications

References 12 publications

Idiopathic pneumatosis intestinalis secondary to lactulose use in patients with cirrhosis

Idiopathic pneumatosis intestinalis secondary to lactulose use in patients with cirrhosis

The appearance of free-air in the abdomen with related pneumatosis cystoides intestinalis: Three case reports and review of the literature

Segmental pneumatosis cystoides coli: Computed tomography-facilitated diagnosis

Contact Info

Product

Resources

About