Management algorithm for pneumatosis intestinalis and portal venous gas: Treatment and outcome of 88 consecutive cases

Journal of Gastrointestinal Surgery

Volumn 14, Issue 3, 2010, Pages 437-448

  Wayne, Erik ^a   Ough, Matthew ^b   Wu, Andrew ^c   Liao, Junlin ^c   Andresen, K J ^c   Kuehn, David ^c   Wilkinson, Neal ^c  

^a University of Louisville School of Medicine   (United States)

^b RUSH UNIVERSITY MEDICAL CENTER   (United States)

^c UNIVERSITY OF IOWA HOSPITALS AND CLINICS   (United States)

Author keywords

Exploratory laparotomy; Mesenteric ischemia; Mesenteric venous gas; Non therapeutic laparotomy; Pneumatosis intestinalis; Portal venous gas

Indexed keywords

ABDOMINAL PAIN; ADULT; AGED; ALGORITHM; ARTICLE; COHORT ANALYSIS; COMPUTER ASSISTED TOMOGRAPHY; FEMALE; GAS; HOSPITALIZATION; HUMAN; ISCHEMIA; LAPAROSCOPY; LAPAROTOMY; MALE; MESENTERY; METHODOLOGY; MIDDLE AGED; MORTALITY; PNEUMATOSIS INTESTINALIS; PORTAL VEIN; RADIOGRAPHY; RETROSPECTIVE STUDY; RISK ASSESSMENT; SURVIVAL RATE; TREATMENT OUTCOME; VASCULARIZATION;

ABDOMINAL PAIN; ADULT; AGED; AGED, 80 AND OVER; ALGORITHMS; COHORT STUDIES; FEMALE; GASES; HUMANS; ISCHEMIA; LAPAROSCOPY; LAPAROTOMY; MALE; MESENTERY; MIDDLE AGED; PNEUMATOSIS CYSTOIDES INTESTINALIS; PORTAL VEIN; RETROSPECTIVE STUDIES; RISK ASSESSMENT; SEVERITY OF ILLNESS INDEX; SURVIVAL RATE; TOMOGRAPHY, X-RAY COMPUTED; TREATMENT OUTCOME;

EID: 77950518552     PISSN: 1091255X     EISSN: None     Source Type: Journal    
DOI: 10.1007/s11605-009-1143-9     Document Type: Article

References (23)

1. Ho LM, Paulson EK, Thompson WM. Pneumatosis intestinalis in the adult: benign to life-threatening causes. American Journal of Roentgenology 2007; 188(6): 1604-1613.
2. Hou SK, Chern CH, How CK, Chen JD, Wang LM, Lee CH. Hepatic portal venous gas: clinical significance of computed tomography findings. American Journal of Emergency Medicine 2004; 22(3): 214-218.
3. St. Peter SD, Abbas MA, Kelly KA. The spectrum of pneumatosis intestinalis. Archives of Surgery 2003; 138(1): 68-75.
4. Kinoshita H, Shinozaki M, Tanimura H, Umemoto Y, Sakaguchi S, Takifuji K, Kawasaki S, Hayashi H, Yamaue H. Clinical features and management of hepatic portal venous gas: four case reports and cumulative review of the literature. Archives of Surgery 2001; 136(12): 1410-1414.
5. Greenstein AJ, Nguyen SQ, Berlin A, Corona J, Lee J, Wong E, Factor SH, Divino CM. Pneumatosis intestinalis in adults: management, surgical indications, and risk factors for mortality. Journal of Gastrointestestinal Surgery 2007; 11(10): 1268-1274.
6. Feczko PJ, Mezwa DG, Farah MC, White BD. Clinical significance of pneumatosis of the bowel wall. Radiographics 1992; 12(6): 1069-1078.
7. McLaughlin SA, Nguyen JH. Conservative management of nongangrenous esophageal and gastric pneumatosis. American Surgeon 2007; 73(9): 862-864.
8. Vanasin B, Wright JR, Schuster MM. Pneumatosis cystoides esophagi. Case report supporting theory of submucosal spread. Journal of the American Medical Association 1971; 217(1): 76-77.
9. Tixedor N, Taourel P, Adell JF, Bruel JM. Extensive esophageal pneumatosis after acute dilatation of the stomach. American Journal of Roentgenology 1998; 171(1): 272-273.
10. Zenooz NA, Robbin MR, Perez V. Gastric pneumatosis following nasogastric tube placement: a case report with literature review. Emergency Radiology 2007; 13(4): 205-207.
11. Rogy MA, Mirza DF, Kovats E, Rauhs R. Pneumatosis cystoides intestinalis (PCI). International Journal of Colorectal Diseases 1990; 5(2): 120-124.
12. Galandiuk S, Fazio VW. Pneumatosis cystoides intestinalis. A review of the literature. Diseases of the Colon and Rectum 1986; 29(5): 358-363.
13. Yale CE, Balish E. Pneumatosis cystoides intestinalis. Diseases of the Colon and Rectum 1976; 19(2): 107-111.
14. Sebastià C, Quiroga S, Espin E, Boyé R, Alvarez-Castells A, Armengol M. Portomesenteric vein gas: pathologic mechanisms, CT findings, and prognosis. Radiographics 2000; 20(5): 1213-224.
15. Chan SC, Wan YL, Cheung YC, Ng SH, Wong AM, Ng KK. Computed tomography findings in fatal cases of enormous hepatic portal venous gas. World Journal of Gastroenterology 2005; 11(19): 2953-2955.
16. University of Iowa Annual Report. http://www. uihealthcare. com/about/annualreport/0607/servicerecord. html (Accessed online 4/24/08).
17. Schindera ST, Triller J, Vock P, Hoppe H. Detection of hepatic portal venous gas: its clinical impact and outcome. Emergency Radiology 2006; 12(4): 164-170.
18. Monneuse O, Pilleul F, Barth X, Gruner L, Allaouchiche B, Valette PJ, Tissot E. Portal venous gas detected on computed tomography in emergency situations: surgery is still necessary. World Journal of Surgery 2007; 31(5): 1065-1071.
19. Morris MS, Gee AC, Cho SD, Limbaugh K, Underwood S, Ham B, Schreiber MA. Management and outcome of pneumatosis intestinalis. American Journal of Surgery 2008; 195(5): 679-682.
20. Iannitti DA, Gregg SC, Mayo-Smith WW, Tomolonis RJ, Cioffi WG, Pricolo VE. Portal venous gas detected by computed tomography: is surgery imperative? Digestive Surgery 2003; 20(4): 306-315.
21. Nelson, AL, Millington TM, Sahani D, Chung RT, Bauer C, Hertl M, Warshaw AL, Conrad C. Hepatic Prtal Venous Gas, The ABCs of Management. Archives of Surgery 2009; 144(6): 575-581.
22. Wiesner W, Mortelé KJ, Glickman JN, Ji H, Ros PR. Pneumatosis intestinalis and portomesenteric venous gas in intestinal ischemia: correlation of CT findings with severity of ischemia and clinical outcome. American Journal of Roentgenology 2001; 177(6): 1319-1323.
23. Liebman PR, Patten MT, Manny J, Benfield JR, Hechtman HB. Hepatic-portal venous gas in adults: etiology, pathophysiology and clinical significance. Annals of Surgery 1978; 187(3): 281-287.