Management and outcome of pneumatosis intestinalis

Melanie S. Morris, Arvin C. Gee, S. David Cho, Kevin Limbaugh, Samantha Underwood, Bruce Ham, Martin A. Schreiber

Research output: Contribution to journalArticle

87 Scopus citations

Abstract

Background: Pneumatosis intestinalis (PI), infiltration of gas into the bowel wall, has traditionally been associated with immediate operative intervention and a high mortality rate. Methods: We retrospectively reviewed the diagnosis and management of pneumatosis in an attempt to characterize the disease, and examined management strategies. Results: Ninety-seven patients had a computed tomography (CT) diagnosis of pneumatosis. The location of pneumatosis was as follows: 46% colon, 27% small bowel, 5% stomach, and 7% both small and large bowel. Fourteen patients also had portal venous gas and 6 (43%) of these patients died. Management strategy was non-operative in 52%, operative in 33%, and futile care in 15%. The overall mortality rate was 22% (16% operative, 6% non-operative, and 87% futile). Patients who died had a higher mean APACHE II score (25 vs 11, P <.001). Conclusions: Approximately 50% of patients with pneumatosis can be successfully managed non-operatively. The combination of PI and portal venous gas may confer a higher mortality rate.

Original languageEnglish (US)
Pages (from-to)679-683
Number of pages5
JournalAmerican journal of surgery
Volume195
Issue number5
DOIs
StatePublished - May 1 2008

Keywords

  • Computed tomorgraphy
  • Laparotomy
  • Non-operative management
  • Pneumatosis intestinalis

ASJC Scopus subject areas

  • Surgery

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