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Undersea Hyperb Med 2020 Second Quarter;47(2):267-270

Dept. of Hyperbaric Medicine, No. 971 Hospital of the People's Liberation Army Navy, Qingdao, 266071, China.

We report the case of a 42-year-old commercial diver who presented with palpitations, arthralgia, tachypnea and vomiting after three hours of repetitive dives to 25-30 meters below sea level (msw). He was diagnosed with severe decompression sickness (Type II DCS) based on his dive history, his abrupt ascent to the surface within minutes, and systemic symptoms with mild hypovolemic shock. Besides remarkable cutis marmorata on the torso, the patient was also found positive for diffuse branch-like pneumatosis in the liver, mesentery and intestines on an abdominal computed tomography (CT). Read More

BMJ Open Gastroenterol 2020 06;7(1)

Medicina Interna, Azienda USL Toscana centro, Ospedale Santa Maria Annunziata, Firenze, Italy.

Introduction: COVID-19 is a respiratory illness due to novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), described in December 2019 in Wuhan (China) and rapidly evolved into a pandemic. Gastrointestinal (GI) tract can also be involved.

Case Presentation: A 44-year-old man was hospitalised for COVID-19-associated pneumonia. Read More

Abdom Radiol (NY) 2020 May 7. Epub 2020 May 7.

Division of Cardiovascular Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.

Purpose: The purpose of this study was to identify the significant imaging predictors of transmural intestinal necrosis in patients with acute mesenteric ischemia (AMI).

Methods: The medical records and CT imaging of 48 patients between 2011 and 2019 suspected of having AMI that underwent exploratory laparotomy with bowel resection and pathological confirmation of ischemic bowel injury were retrospectively reviewed. Using histopathology as a gold standard, various parameters related to vascular insufficiency and bowel injury were analyzed and correlated with outcome of ischemic bowel necrosis using nonparametric tests. Read More

Medicine (Baltimore) 2020 Apr;99(17):e19810

Department of Critical Care Medicine, Zhejiang Hospital, Hangzhou, PR China.

Introduction: Hepatic portal venous gas (HPVG) is a rare imaging finding. When HPVG is accompanied with pneumatosis intestinalis (PI), the underlying cause is usually mesenteric ischemia with consequent intestinal necrosis. This combination of clinical conditions is associated with a poor prognosis. Read More

Cardiol Young 2020 May 3;30(5):624-628. Epub 2020 Apr 3.

Heart and Lung Department, Cardiothoracic Intensive Care Unit, Great Ormond Street Children's Hospital, London, UK.

Neonates with CHD are at increased risk of developing necrotising enterocolitis due to mesenteric hypoperfusion. Necrotising enterocolitis results in repeated feed interruptions contributing to poor growth during the early post-operative phase. Poor weight gain and longer hospital stay are risk factors for death in neonates with CHD. Read More

J Med Ultrasound 2019 Oct-Dec;27(4):211-212. Epub 2019 Jun 7.

Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.

Dis Colon Rectum 2020 Mar;63(3):381-388

Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, Texas.

Background: Patients undergoing chemotherapy are at risk for mucosal injury and neutropenia, which facilitate colonic mucosal invasion by the bowel flora and subsequent neutropenic enterocolitis, which has a poor prognosis.

Objective: This study aimed to assess the clinical features and outcomes of neutropenic enterocolitis in patients at a comprehensive cancer center.

Design: This is a retrospective cohort study. Read More

Singapore Med J 2019 Nov;60(11):566-573

Department of Radiology, Changi General Hospital, Singapore.

A 74-year-old woman receiving long-term anticoagulation with warfarin for chronic atrial fibrillation presented with severe acute abdominal pain, diarrhoea and vomiting. Initial laboratory workup revealed a deranged coagulation profile. Computed tomography of the abdomen and pelvis demonstrated spontaneous distal jejunal intramural haematoma with associated reactive ileus. Read More

Dtsch Med Wochenschr 2019 11 21;144(23):1638-1641. Epub 2019 Nov 21.

Klinik für Allgemein-, Viszeral- und Thoraxchirurgie.

History: A 67-year-old woman was found lying naked on the bathroom floor for at least the last 12 hours. She had a medical history of insulin-dependent diabetes mellitus type 2 and a resection of the cecal pole.

Examinations: The patient was hypotonic (60/40 mmHg), hypothermic (29 °C) and hyperglycemic. Read More

Acute Crit Care 2019 Feb 17;34(1):81-85. Epub 2017 Jan 17.

Department of Surgery, Chosun University Hospital, Gwangju, Korea.

Pneumatosis intestinalis (PI) is a rare condition of the presence of gas within the bowel walls. PI is associated with numerous underlying diseases, ranging from life-threatening to innocuous conditions. PI is believed to be secondary to coexisting disorders in approximately 85% of all cases. Read More

Isr Med Assoc J 2019 Nov;21(11):763-765

Department of Pediatrics, Assuta Ashdod Medical Center, Ashdod, Israel.

BMC Gastroenterol 2019 Nov 6;19(1):176. Epub 2019 Nov 6.

Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1277, Jiefang Avenue, Wuhan, Hubei province, China.

Background: Pneumatosis cystoides intestinalis (PCI) is a low-incidence disease that confuses many doctors. A vast number of factors are suspected to contribute to its pathogenesis, such as Crohn's disease, intestinal stenosis, ulcerative colitis, drug use, extra-gastrointestinal diseases, and chronic obstructive pulmonary disease. Most consider its pathogenesis interrelated to an increase in intra-intestinal pressure and the accumulation of gas produced by aerogenic bacteria, and patients with atypical symptoms and imaging manifestations tend to be misdiagnosed. Read More

J Gastroenterol Hepatol 2020 Jun 9;35(6):1065-1068. Epub 2019 Dec 9.

Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

Background And Aim: Few case reports exist that link lactulose use with pneumatosis intestinalis in cirrhotics. This study investigates the relationship between lactulose use and idiopathic pneumatosis intestinalis in a cohort of cirrhotic patients.

Methods: This case series considers several notable cases of patients with idiopathic pneumatosis intestinalis and concurrent lactulose use. Read More

Acta Med Port 2019 Oct;32(10):676

Department of Pediatric Surgery. Centro Hospitalar Universitário São João. Faculty of Medicine. Porto.

AJR Am J Roentgenol 2020 01 25;214(1):90-95. Epub 2019 Sep 25.

Service de Radiologie, CHU Besançon, 3 Blvd Fleming, Besançon, France 25000.

The purpose of this study was to assess whether transmural bowel necrosis has distinct CT features based on the three main causes: occlusive acute mesenteric ischemia (AMI), nonocclusive AMI, and strangulated small-bowel obstruction (SBO). From January 2010 to December 2017, the records of all patients with a pathologic diagnosis of transmural bowel necrosis were extracted from the pathology department database of a university hospital. The inclusion criteria for the study were presence of transmural bowel necrosis at pathologic examination and available contrast-enhanced CT images obtained within the 24 hours before surgery. Read More

Int J Surg Case Rep 2019 1;62:100-102. Epub 2019 Aug 1.

Department of Radiology La Rabta University Hospital, Tunis, Tunisia. Electronic address:

Introduction: Pneumatosis cystoides intestinalis (PCI) is a condition defined by the presence of multiple gas-filled cysts within the intestinal wall. We demonstrated a case of PCI presenting as pneumoperitoneum following a hand-to-hand aggression. Consent was obtained from the patient for publication of this paper. Read More

Med Ultrason 2019 Aug;21(3):299-315

National Centre for Ultrasound in Gastroenterology, Department of Medicine, Haukeland University Hospital, Bergen, and Department of Clinical Medicine, University of Bergen, Norway.

Transabdominal gastrointestinal ultrasound (GIUS) is unique in its capacity to examine the bowel non-invasively and in its physiological condition, including extra-intestinal features such as the splanchnic vessels, mesentery, omentum and lymph nodes- even at the bedside. Despite this, and its extensive documentation for its usefulness, it has only been fully implemented in a few European countries and expert centres. Therefore, the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) established a GIUS Task Force Group in 2014 consisting of international experts from 9 European countries with the objectives to standardize and promote the use of GIUS in a clinical setting. Read More

Int J Colorectal Dis 2019 Oct 30;34(10):1805-1808. Epub 2019 Aug 30.

Division of Colon and Rectal Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, No. 325, Section 2, Cheng-Kong Rd., Neihu District, Taipei, Taiwan.

Background: Although pneumatosis cystoides intestinalis (PCI) is observed in patients who are on corticosteroid treatment, most patients have underlying diseases requiring long-term corticosteroid treatment. Herein, we present a rare case of a patient with aseptic meningitis who had PCI of the ascending colon while receiving betamethasone treatment.

Case Presentation: A 46-year-old man was sent to our institution due to disturbance in consciousness and general weakness. Read More

Dig Dis Sci 2019 10;64(10):2769-2775

Departments of Emergency Surgery and Gastroenterology, St. Orsola University Hospital, Bologna, Italy.

Introduction: Pneumatosis cystoides intestinalis (PCI) is a rare condition characterized by the presence of intramural gas cysts within the small and large intestines. We describe a case of a 70-year-old man admitted to the Emergency Surgery Department for PCI who was treated conservatively.

Areas Covered: We reviewed 60 cases of PCI described in the international literature over the last 5 years. Read More

BMJ Case Rep 2019 Jul 30;12(7). Epub 2019 Jul 30.

Department of Pathology, Unity Hospital, Greece, New York, USA.

A 75-year-old woman with rheumatoid arthritis on rituximab presented with a 1-week history of constipation and abdominal distension. Subsequent workup showed presence of air in the bowel wall without perforation initially. Due to positive blood cultures, worsening leucocytosis and high suspicion for perforation, an exploratory laparotomy was performed revealing necrotic bowel, walled off perforation and abscess. Read More

Toxicol Ind Health 2019 Jul;35(7):482-485

1 Department of Emergency, Taihe Hospital, Hubei University of Medicine, Shiyan City, China.

Acute organophosphorus pesticide poisoning (AOPP) is fairly common in rural areas of Asia. The symptoms of AOPP are mainly caused by acetylcholine accumulation. According to the clinical characteristics, AOPP symptoms can fall into the following three categories: muscarinic, nicotinic, and central. Read More

Scand J Gastroenterol 2019 Aug 30;54(8):953-959. Epub 2019 Jul 30.

Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University , Nanjing , China.

Acute mesenteric ischemia (AMI) is a rare life-threatening condition, especially for the patients with transmural intestinal necrosis (TIN). However, the optimal time for surgical intervention is controversial. As a series study, this study aimed to identify the outcomes and clinical characteristic of patients with TIN. Read More

Rofo 2019 Nov 25;191(11):975-977. Epub 2019 Jul 25.

BAG Dr. Richter & Dr. Stumpp, Practice for Radiology, Wurzen, Germany.

Pediatr Int 2019 Jul 18;61(7):733-735. Epub 2019 Jul 18.

Department of Radiology, Saitama Children's Medical Center, Saitama, , Japan.

Gastroenterol Hepatol 2019 Nov 15;42(9):557-558. Epub 2019 Jul 15.

Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Ribera, Alzira, Valencia, España.

Medicine (Baltimore) 2019 Jul;98(28):e16202

Scientific Research Department, Qilu Hospital of Shandong University, Jinan, Shandong, China.

The purpose of this study was to explore the diagnostic significance of abdominal sonography (AUS) in infants with Necrotizing enterocolitis (NEC) admitted to a neonatal intensive care unit to better evaluate the ability of AUS to differentiate necrotizing enterocolitis from other intestinal diseases.All patients diagnosed with NEC at the Department of General Surgery and Neonatal Surgery, Qilu Children's Hospital between 1st, Jun, 2010 and 30th, Dec, 2015. The logistic regression analysis and the area under receiver operating characteristic (ROC) curve (AUCs) were also used to identify the sonographic factors for diagnosing NEC. Read More

Am J Emerg Med 2019 10 24;37(10):1993.e1-1993.e3. Epub 2019 Jun 24.

Department of Emergency Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan. Electronic address:

Pneumatosis intestinalis (PI) refers to the presence of gas within the wall of the small or large intestine. PI can be both asymptomatic and life-threatening. The patient was a 50-year-old man with previous cervical spine abscess and osteomyelitis post debridement 4 years ago, with a heroin abuse history. Read More

J Community Hosp Intern Med Perspect 2019 19;9(3):244-246. Epub 2019 Jun 19.

Internal Medicine, Richmond University Medical Center, Staten Island, NY, USA.

Gastric emphysema is a rare medical condition in which air penetrates any layer of the gastric wall (mucosa, submucosa, muscle layer, or serosa) due to a noninfectious source. It is essential to differentiate this from a life-threatening condition known as emphysematous gastritis. These two conditions have a similar presentation, and therefore, it is difficult to differentiate the two on imaging. Read More

Intern Med 2019 Oct 7;58(19):2857-2859. Epub 2019 Jun 7.

Department of Neurology, Kamagaya General Hospital, Japan.

This manuscript describes the first known case of a patient with multiple system atrophy whose parasympathetic dominant disturbance might have been associated with the relative constriction of the superior mesenteric artery, leading to nonocclusive mesenteric ischemia and subsequent portomesenteric venous gas with pneumatosis intestinalis on abdominal computed tomography approaching death. Read More

Ulster Med J 2019 Jan 22;88(1):56. Epub 2019 Jan 22.

Scottish National Advanced Heart Failure Service, Golden Jubilee National Hospital, Glasgow, G81 4DY, UK.

Medicine (Baltimore) 2019 May;98(18):e15480

Division of Gastroenterology and Hepatology.

Rationale: Chronic intestinal pseudo-obstruction (CIPO) and pneumatosis cystoides intestinalis (PCI) are rare abdominal diseases and the pathological mechanisms have not been fully elucidated. Systemic sclerosis (SSc), which is characterized by the progressive sclerotic changes of skin and internal organs, is a refractory collagen disease and is frequently associated with digestive disorders including CIPO.

Patient Concerns: A 68-year-old woman who has been well managed for SSc over the long term, who presented with abdominal fullness for the first time. Read More

N Engl J Med 2019 Mar;380(13):e17

Cambridge University Hospitals, Cambridge, United Kingdom

Am Surg 2019 Feb;85(2):e69-e70

Med Ultrason 2019 Feb;21(1):30-36

Department of Radiology, Saitama Children's Medical Center, Saitama, Japan.

Aims: To evaluate ultrasound findings in order to determine potential predictors of prognosis in pediatric patients with portal venous gas (PVG) detected by ultrasound.

Materials And Methods: Thirty-nine children were included and divided into two groups: benign PVG (n=24) and life-threatening PVG (n=15; 6 surgical interventions and 9 deaths). Possible predictors, i. Read More

Clin Perinatol 2019 03 20;46(1):119-127. Epub 2018 Dec 20.

SPIN Program, San Diego Mothers' Milk Bank, Division of Neonatology, UC San Diego, 9300 Campus Point Drive MC7774, La Jolla, CA 92037, USA; Division of Pediatric Gastroenterology, Hepatology and Nutrition, Rady Children's Hospital-San Diego, 3020 Children's Way, San Diego, CA 92123. Electronic address:

Current assessment for and diagnosis of necrotizing enterocolitis (NEC) remain inadequate. The introduction of interrogating bowel with ultrasound when NEC is suspected or when NEC has occurred presents greater opportunity to characterize the physical changes that have occurred in the bowel wall structures. The evaluation of bowel by ultrasound has been shown to have high specificity for bowel necrosis. Read More

World Neurosurg 2019 05 11;125:312-315. Epub 2019 Feb 11.

Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. Electronic address:

Background: Pneumoperitoneum after surgical manipulation of the abdomen implies a perforation. Rare cases of nonoperated cancer patients, largely with gastrointestinal or genitourinary cancers, have been noted to have radiologic findings of pneumatosis intestinalis and/or pneumoperitoneum as a complication of molecular-targeted therapy (MTT) without confounding factors for perforation. We present a patient with a cranial malignancy treated with bevacizumab who subsequently manifested with pneumatosis intestinalis. Read More

BMC Surg 2019 Feb 4;19(1):17. Epub 2019 Feb 4.

Department of Hepatobiliary Surgery, the Second Affiliated Hospital, Nanchang University, No. 1, mingde road, Nanchang, Jiang xi, China.

Background: Hepatic portal vein gas (HPVG) is a rare acute abdomen, which is not an independent disease. Meanwhile, HPVG combined with appendicitis has been rarely reported. We found only a similar report by looking for literature, but no intestinal necrosis occurred. Read More

Clin Gastroenterol Hepatol 2020 May 30;18(5):A35-A36. Epub 2019 Jan 30.

Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

BMC Pediatr 2019 01 15;19(1):21. Epub 2019 Jan 15.

Department of Pediatric Emergency Medicine, Children's Hospital, China Medical University, Taichung, Taiwan.

Background: Pneumatosis intestinalis and portomesenteric venous gas are usually caused by necrotizing enterocolitis; however they can occur secondary to abusive abdominal trauma with bone fractures and bruising. It is difficult to recognize initially if there is no bruising on the skin or bone fractures.

Case Presentation: We report a 1-year-old child with no obvious history of trauma who presented with conscious disturbance. Read More

Radiology 2019 03 15;290(3):619. Epub 2019 Jan 15.

From the Division of Colorectal Surgery, Department of Surgery, Changhua Christian Hospital, 135 Nanxiao St, Changhua City, Changhua County 500, Taiwan.

Am J Med Sci 2019 03 29;357(3):e9. Epub 2018 Nov 29.

Division of Gastroenterology and Hepatology, Elmhurst Hospital Center, Elmhurst, New York.

Medicine (Baltimore) 2019 Jan;98(2):e14079

Department of Diagnostic Pathology.

Rationale: Pneumatosis intestinalis (PI) and hepatic portal venous gas (HPVG) are rare but potentially lethal conditions in which gas pathologically accumulates in the portal vein and intestinal wall, respectively. Proposed mechanisms include flatus escaping through an injured intestinal mucosa into the submucosa and thence into the portal venous system, or bacterial translocation (BT) of gas-forming enteric microorganisms from the gut into and through the intestinal wall to other organs. However, there has been no clear histopathological evidence to support these hypotheses. Read More

G Chir 2018 Nov-Dec;39(6):391-394

Introduction: Pneumatosis intestinalis (PI) is described as the presence of air within bowel wall. PI aetiology is various: it can be associated with non-urgent or life-threatening conditions. Clinical management is based on physical examination, blood tests and radiology, in particular abdominal CT. Read More

Acta Chir Belg 2019 06 29;119(3):205-206. Epub 2018 Oct 29.

a Department of General and Digestive Surgery , Hospital Universitario de la Princesa , Madrid , Spain.

Int J Surg Case Rep 2018 9;52:84-88. Epub 2018 Oct 9.

Department of General Surgery, General Hospital of Drama, Drama, Greece.

Introduction: Pneumatosis intestinalis is a rare condition that may be idiopathic or a sign of numerous underlying gastrointestinal, pulmonary and systemic diseases.

Presentation Of Case: Herein, the case an otherwise-healthy 82-year-old female patient with vague abdominal pain due to total colonic pneumatosis 20 days after completion of R-CHOP chemotherapy for a stage IIE primary non-Hodgkin's lymphoma of the terminal ileum submitted to right hemicolectomy and ileal resection 6 months previously is presented. As no evidence of intramural bowel gas was present on pre-operative CT, pneumatosis coli considered to be secondary. Read More

Rev Assoc Med Bras (1992) 2018 Jun;64(6):543-548

Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul, South Korea.

Objective: To assess the diagnostic performance of CT findings in differentiating causes of pneumatosis intestinalis (PI), including benign and life-threatening causes.

Methods: All CT reports containing the word "pneumatosis" were queried from June 1st, 2006 to May 31st, 2015. A total of 42 patients with PI were enrolled (mean age, 63. Read More

Rev Fac Cien Med Univ Nac Cordoba 2018 09 22;75(3):205-211. Epub 2018 Sep 22.

Hospital Nacional de Clínicas - FCM - UNC.

Objective: To present a recent to increase understanding, diagnosis and treatment of intestinal pneumatosis clinical case, considering the distinctive characteristics of the disease and to expand knowledge about the management of this condition.

Methods: The case of a female patient aged 65, originally from Bolivia, with a history of osteoarthritis, osteoporosis, asthma and allergies repetition occurs. The patient was admitted to the Department of Surgery No. Read More

BMJ Case Rep 2018 Sep 28;2018. Epub 2018 Sep 28.

Department of Gastroenterology, Austin Hospital, Heidelberg, Victoria, Australia.

Pneumatosis cystoides intestinalis (PCI) refers to the presence of gas within the wall of the small or large intestine. The pathophysiology is incompletely understood and is probably multifactorial in nature. PCI is a known but rare complication of systemic scleroderma, and the aetiology of PCI in patients with scleroderma is not fully understood. Read More

J Visc Surg 2019 Apr 22;156(2):177-178. Epub 2018 Sep 22.

Departments of Surgery, National Taiwan University Hospital, No.7 Chung-Shan South Road, Taipei 100, Taiwan. Electronic address:

Pneumatosis cystoides intestinalis is generally benign in course and sometimes, if cysts ruptured, behave as the not uncommon cause of free air in acute abdomen. In our case, we illustrate ruptured isolated cysts of pneumatosis cystoides intestinalis are responsible for pneumoperitoneum in a 94-year-old male patient. Laparotomy with gastrotomy for decompression of intraluminal aeropressure was performed, with an uneventful recovery. Read More

BMJ 2018 Aug 30;362:k2945. Epub 2018 Aug 30.

KSS Deanery.