TY - JOUR
T1 - Management and outcome of pneumatosis intestinalis
AU - Morris, Melanie S.
AU - Gee, Arvin C.
AU - Cho, S. David
AU - Limbaugh, Kevin
AU - Underwood, Samantha
AU - Ham, Lyle (Bruce)
AU - Schreiber, Martin A.
PY - 2008/5
Y1 - 2008/5
N2 - 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.
AB - 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.
KW - Computed tomorgraphy
KW - Laparotomy
KW - Non-operative management
KW - Pneumatosis intestinalis
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U2 - 10.1016/j.amjsurg.2008.01.011
DO - 10.1016/j.amjsurg.2008.01.011
M3 - Article
C2 - 18424288
AN - SCOPUS:42049084144
SN - 0002-9610
VL - 195
SP - 679
EP - 683
JO - American journal of surgery
JF - American journal of surgery
IS - 5
ER -