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Pneumatosis Intestinalis with Pneumoperitoneum Mimicking Intestinal Perforation in a Patient with Myelodysplastic Syndrome after Hematopoietic Stem Cell Transplantation

Pneumatosis intestinalis (PI) is an uncommon disorder characterized by an accumulation of gas in the bowel wall, and has been associated with a variety of disorders and procedures. We describe a 35-year-old man who undertook hematopoietic stem cell transplantation due to myelodysplastic syndrome. An...

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Autores principales: Keam, Bhumsuk, Lee, Jeong-Hoon, Oh, Myoung-Don, Kim, Inho, Yoon, Sung-Soo, Kim, Byoung Kook, Park, Seonyang
Formato: Texto
Lenguaje:English
Publicado: The Korean Association of Internal Medicine 2007
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2687608/
https://www.ncbi.nlm.nih.gov/pubmed/17427646
http://dx.doi.org/10.3904/kjim.2007.22.1.40
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author Keam, Bhumsuk
Lee, Jeong-Hoon
Oh, Myoung-Don
Kim, Inho
Yoon, Sung-Soo
Kim, Byoung Kook
Park, Seonyang
author_facet Keam, Bhumsuk
Lee, Jeong-Hoon
Oh, Myoung-Don
Kim, Inho
Yoon, Sung-Soo
Kim, Byoung Kook
Park, Seonyang
author_sort Keam, Bhumsuk
collection PubMed
description Pneumatosis intestinalis (PI) is an uncommon disorder characterized by an accumulation of gas in the bowel wall, and has been associated with a variety of disorders and procedures. We describe a 35-year-old man who undertook hematopoietic stem cell transplantation due to myelodysplastic syndrome. An abdominal X-ray demonstrated extensive PI with pneumoperitoneum mimicking hollow organ perforation. However, the patient had no abdominal symptoms and there was no evidence of peritoneal inflammation. After two weeks of conservative management, including bowel rest and antibiotics, his pneumoperitoneum resolved spontaneously without any complications. Of the many factors that affect the gastrointestinal tract mucosal integrity, intramural pressure, and bacterial flora-produced intraluminal gas interact to produce PI. If the condition is accompanied by bowel ischemia, portomesenteric venous gas, metabolic acidosis, and abdominal sepsis, or if PI is severe in extent immediate surgical intervention is indicated. The described case supports that a mechanical rather than a bacterial etiology underlies the pathogenesis of PI.
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spelling pubmed-26876082009-06-15 Pneumatosis Intestinalis with Pneumoperitoneum Mimicking Intestinal Perforation in a Patient with Myelodysplastic Syndrome after Hematopoietic Stem Cell Transplantation Keam, Bhumsuk Lee, Jeong-Hoon Oh, Myoung-Don Kim, Inho Yoon, Sung-Soo Kim, Byoung Kook Park, Seonyang Korean J Intern Med Case Report Pneumatosis intestinalis (PI) is an uncommon disorder characterized by an accumulation of gas in the bowel wall, and has been associated with a variety of disorders and procedures. We describe a 35-year-old man who undertook hematopoietic stem cell transplantation due to myelodysplastic syndrome. An abdominal X-ray demonstrated extensive PI with pneumoperitoneum mimicking hollow organ perforation. However, the patient had no abdominal symptoms and there was no evidence of peritoneal inflammation. After two weeks of conservative management, including bowel rest and antibiotics, his pneumoperitoneum resolved spontaneously without any complications. Of the many factors that affect the gastrointestinal tract mucosal integrity, intramural pressure, and bacterial flora-produced intraluminal gas interact to produce PI. If the condition is accompanied by bowel ischemia, portomesenteric venous gas, metabolic acidosis, and abdominal sepsis, or if PI is severe in extent immediate surgical intervention is indicated. The described case supports that a mechanical rather than a bacterial etiology underlies the pathogenesis of PI. The Korean Association of Internal Medicine 2007-03 2007-03-31 /pmc/articles/PMC2687608/ /pubmed/17427646 http://dx.doi.org/10.3904/kjim.2007.22.1.40 Text en Copyright © 2007 The Korean Association of Internal Medicine https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Keam, Bhumsuk
Lee, Jeong-Hoon
Oh, Myoung-Don
Kim, Inho
Yoon, Sung-Soo
Kim, Byoung Kook
Park, Seonyang
Pneumatosis Intestinalis with Pneumoperitoneum Mimicking Intestinal Perforation in a Patient with Myelodysplastic Syndrome after Hematopoietic Stem Cell Transplantation
title Pneumatosis Intestinalis with Pneumoperitoneum Mimicking Intestinal Perforation in a Patient with Myelodysplastic Syndrome after Hematopoietic Stem Cell Transplantation
title_full Pneumatosis Intestinalis with Pneumoperitoneum Mimicking Intestinal Perforation in a Patient with Myelodysplastic Syndrome after Hematopoietic Stem Cell Transplantation
title_fullStr Pneumatosis Intestinalis with Pneumoperitoneum Mimicking Intestinal Perforation in a Patient with Myelodysplastic Syndrome after Hematopoietic Stem Cell Transplantation
title_full_unstemmed Pneumatosis Intestinalis with Pneumoperitoneum Mimicking Intestinal Perforation in a Patient with Myelodysplastic Syndrome after Hematopoietic Stem Cell Transplantation
title_short Pneumatosis Intestinalis with Pneumoperitoneum Mimicking Intestinal Perforation in a Patient with Myelodysplastic Syndrome after Hematopoietic Stem Cell Transplantation
title_sort pneumatosis intestinalis with pneumoperitoneum mimicking intestinal perforation in a patient with myelodysplastic syndrome after hematopoietic stem cell transplantation
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2687608/
https://www.ncbi.nlm.nih.gov/pubmed/17427646
http://dx.doi.org/10.3904/kjim.2007.22.1.40
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