Pneumatosis Intestinalis With a Focus on Hyperbaric Oxygen Therapy

Abstract

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.

Improvements in Pneumatosis Cystoides Intestinalis and Hepatic Portal Venous Gas with Conservative Therapy in a Patient on Maintenance Dialysis

“…This condition is idiopathic in 15% of patients; however, in 85% of patients, an underlying condition is present, such as intestinal obstruction, ischemic intestinal disease, inflammatory bowel disease, chronic obstructive pulmonary disease or collagen disease (4). There are several theories regarding its etiology, such as a mechanical theory involving an increased intestinal pressure and a bacterial theory that involves gasproducing microorganisms (5). Emergency surgery is indicated if intestinal necrosis is present, but should also be considered in cases of: 1) patients aged 60 years or older, 2) a leukocyte level of more than 12,000/μL, 3) vomiting, 4) HPVG, 5) septicemia or 6) acidosis (6).…”

Pneumatose Cólica Tratada com Metronidazol e Oxigenoterapia Hiperbárica: Um Caso de Sucesso

“…Complicações, como oclusão intestinal, volvo, invaginação, pneumoperitoneu e hemorragia, ocorrem em aproximadamente 3% dos doentes. 7 O diagnóstico baseia-se em técnicas de imagem. A TC é o método mais sensível e pode identificar a patologia subjacente e complicações associadas.…”

“…Apesar de não existirem ensaios clínicos randomizados, numa revisão recente de Feuerstein JD et al, 7 identificaram-se 35 casos cujo tratamento foi a OHB. Obteve-se resolução ou melhoria sintomática em 89% dos doentes.…”

Neumatosis intestinal, un hallazgo intraoperatorio inusual

“…Esta enfermedad se caracteriza por la presencia de gas en la pared del intestino (1-5) y, por lo general, se diagnostica como un hallazgo radiológico incidental (3,6). La patogenia es aún desconocida, pero existen varias teorías: mecánica, bacteriana, bioquímica y dietética (1,4,7,8).…”

“…La patogenia es aún desconocida, pero existen varias teorías: mecánica, bacteriana, bioquímica y dietética (1,4,7,8). Su etiología es diversa (2,3) y se clasifica de acuerdo a su causa y a su pronóstico en primaria (15%) y secundaria (85%) (6,8). La NI puede tener un curso benigno o presentarse como una enfermedad más grave (2,3,(7)(8)(9)(10).…”