|
-- OR -- |
|
- Pneumatosis Intestinalis: CT Findings
- Low density linear or bubbly pattern of gas in the bowel wall
- May be benign finding or a life threatening finding - “ The frequency of detection of pneumatosis intestinalis (PI) appears to be increasing. The increase may be the result of increased CT use. New medications and surgical procedures have been reported to be associated with an increase in the incidence of PI.”
Pneumatosis Intestinalis in the Adult: Benign to Life-threatening Causes
Ho LM et al
AJR 2007; 188:1804-1813 - Pneumatosis Intestinalis: Benign Causes
- Pulmonary
- Systemic diseases
- Intestinal causes
- Iatrogenic
- Medications
- Organ transplantation
- Idiopathic - Pneumatosis Intestinalis: Benign Causes-Pulmonary
- Asthma
- Bronchitis
- Emphysema
- Pulmonary fibrosis
- Cystic fibrosis
- PEEP - Pneumatosis Intestinalis: Benign Causes-Systemic Diseases
- Scleroderma
- Systemic lupus (SLE)
- AIDS - Pneumatosis Intestinalis: Benign Causes-Intestinal Causes
- Pyloric stenosis
- Enteritis
- Bowel obstruction
- Ulcerative colitis
- Leukemia
- Intestinal parasites
- diverticulitis - Pneumatosis Intestinalis: Benign Causes-Iatrogenic
- Barium enema
- Jejunoileal bypass
- Jejunostomy tubes
- Postsurgical anastomosis
- endoscopy - Pneumatosis Intestinalis: Benign Causes-Medications
- Corticosteroids
- Chemotherapeutic agents
- Lactulose
- Sorbitol - Pneumatosis Intestinalis: Benign Causes-Organ Tx’s
- Bone marrow
- Kidney
- Liver
- Cardiac
- Lung
- GVH - Pneumatosis Intestinalis: Life Threatening Causes
- Intestinal ischemia
- Mesenteric vascular disease
- Intestinal obstruction
- Toxic megacolon
- Organ transplantation (usually BMT)
- Collagen vascular disease - Portal Venous Gas - Differential Dx
- ischemic bowel
- vascular catheterization
- diverticulitis
- acute gastric dilatation
- acute intestinal dilatation
- peptic ulceration
- post-colonoscopy
- post-ERCP
"We observed the presence of portal venous gas associated with intestinal pneumatosis in 25.5% of cases. In patients having both IP and PVG intestinal infarction was observed in 69.2% of cases."
Intestinal Pneumatosis in adults: diagnostic and prognostic value
Lassandro F et al.
Emerg Radiol (2010) 17:361-365"We have retrospectively evaluated 102 patients correlating the CT finding of gastrointestinal parietal gas with clinical data and outcome. Fifty three patients (52%) had surgical evidence of intestinal infarction."
Intestinal Pneumatosis in adults: diagnostic and prognostic value
Lassandro F et al.
Emerg Radiol (2010) 17:361-365" In our study intestinal pneumatosis has been observed in a broad range of lesions with very different prognosis, the most frequent of which was intestinal infarction. When associated with portal venous gas, there was a much higher prevalence of intestinal infarct, and the prognosis was definitely worse."
Intestinal Pneumatosis in adults: diagnostic and prognostic value
Lassandro F et al.
Emerg Radiol (2010) 17:361-365- Pneumatosis Intestinalis: Causes
- Ischemic bowel
- Intestinal obstruction
- Cancer
- Volvulus
- Ulcer
- Hernia
- Trauma
- Crohns disease
- Acute gastric dilatation
- Organ transplantation
- s/p ERCP
- Barium enema
- s/p Organ transplant
- AIDS
- Leukemia
- Collagen vascular disease
- Diverticulitis
- Iatrogenic causes (i.e. colon biopsy)