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Pneumatosis intestinalis a trap for the unwary: Case series and literature review
INTRODUCTION: Pneumatosis Intestinalis (PI) can present with a broad range of presentations from chronic and non-specific to acute and life threatening. It is paradoxically one of the few conditions where a pneumoperitoneum found in the diagnostic workup is not necessarily an indication for laparoto...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6232619/ https://www.ncbi.nlm.nih.gov/pubmed/30428434 http://dx.doi.org/10.1016/j.ijscr.2018.10.079 |
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author | Dhadlie, Sunny Mehanna, Daniel McCourtney, James |
author_facet | Dhadlie, Sunny Mehanna, Daniel McCourtney, James |
author_sort | Dhadlie, Sunny |
collection | PubMed |
description | INTRODUCTION: Pneumatosis Intestinalis (PI) can present with a broad range of presentations from chronic and non-specific to acute and life threatening. It is paradoxically one of the few conditions where a pneumoperitoneum found in the diagnostic workup is not necessarily an indication for laparotomy. PRESENTATION OF CASES: The first case is of a 75 year old gentlemen who attended the emergency department after several weeks of worsening abdominal pain and weight loss. At laparotomy, two segments of nodular, abnormal-looking small bowel were identified with bubbles of air seen in the small bowel mesentery. The second case is of an 86 year old man with of a 5-month history of abdominal pain, weight loss, nausea and diarrhoea. A subsequent endoscopy revealed diffuse gastritis with a small antral gastric ulcer with a small amount of blood. The CT scan demonstrated free air within the bowel wall, with a follow up scan performed 3 weeks later revealing an increase in the amount of free air. DISCUSSION: PI is a rare condition characterised by the presence of subserosal and submucosal gas filled cysts occurring anywhere in the gastrointestinal tract from the oesophagus to the anus. Numerous conditions have been associated with PI including bowel obstruction, infections, ischemia and there have been reported cases suggesting as association with Crohn’s disease. CONCLUSION: PI is a condition that may manifest with a wide range of symptoms from mild abdominal pain to acute peritonitis. Its treatment is generally medical and even with radiological evidence of perforation laparotomy may not be indicated if the patient is clinically well. |
format | Online Article Text |
id | pubmed-6232619 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-62326192018-11-29 Pneumatosis intestinalis a trap for the unwary: Case series and literature review Dhadlie, Sunny Mehanna, Daniel McCourtney, James Int J Surg Case Rep Article INTRODUCTION: Pneumatosis Intestinalis (PI) can present with a broad range of presentations from chronic and non-specific to acute and life threatening. It is paradoxically one of the few conditions where a pneumoperitoneum found in the diagnostic workup is not necessarily an indication for laparotomy. PRESENTATION OF CASES: The first case is of a 75 year old gentlemen who attended the emergency department after several weeks of worsening abdominal pain and weight loss. At laparotomy, two segments of nodular, abnormal-looking small bowel were identified with bubbles of air seen in the small bowel mesentery. The second case is of an 86 year old man with of a 5-month history of abdominal pain, weight loss, nausea and diarrhoea. A subsequent endoscopy revealed diffuse gastritis with a small antral gastric ulcer with a small amount of blood. The CT scan demonstrated free air within the bowel wall, with a follow up scan performed 3 weeks later revealing an increase in the amount of free air. DISCUSSION: PI is a rare condition characterised by the presence of subserosal and submucosal gas filled cysts occurring anywhere in the gastrointestinal tract from the oesophagus to the anus. Numerous conditions have been associated with PI including bowel obstruction, infections, ischemia and there have been reported cases suggesting as association with Crohn’s disease. CONCLUSION: PI is a condition that may manifest with a wide range of symptoms from mild abdominal pain to acute peritonitis. Its treatment is generally medical and even with radiological evidence of perforation laparotomy may not be indicated if the patient is clinically well. Elsevier 2018-11-02 /pmc/articles/PMC6232619/ /pubmed/30428434 http://dx.doi.org/10.1016/j.ijscr.2018.10.079 Text en © 2018 The Authors http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Dhadlie, Sunny Mehanna, Daniel McCourtney, James Pneumatosis intestinalis a trap for the unwary: Case series and literature review |
title | Pneumatosis intestinalis a trap for the unwary: Case series and literature review |
title_full | Pneumatosis intestinalis a trap for the unwary: Case series and literature review |
title_fullStr | Pneumatosis intestinalis a trap for the unwary: Case series and literature review |
title_full_unstemmed | Pneumatosis intestinalis a trap for the unwary: Case series and literature review |
title_short | Pneumatosis intestinalis a trap for the unwary: Case series and literature review |
title_sort | pneumatosis intestinalis a trap for the unwary: case series and literature review |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6232619/ https://www.ncbi.nlm.nih.gov/pubmed/30428434 http://dx.doi.org/10.1016/j.ijscr.2018.10.079 |
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