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BMC Gastroenterol 2022 Jun 20;22(1):300. Epub 2022 Jun 20.

Department of Surgery, Valleywise Health Medical Center, Phoenix, AZ, USA.

Background: Small intestinal bacterial overgrowth (SIBO) is a condition of unknown prevalence characterized by an excessive amount of bacteria in the small bowel, typically resulting in vague gastrointestinal symptoms with bloating being most commonly reported. Here we describe a severe case of SIBO leading to small bowel necrosis requiring surgical intervention.

Case Presentation: A 55-year-old Hispanic female with gastric outlet obstruction secondary to a newly diagnosed gastric adenocarcinoma, receiving neoadjuvant chemotherapy, developed bloody gastrostomy output and rapidly progressing nausea and abdominal distention 3 days after jejunostomy tube placement and initiation of jejunal enteral nutrition. Read More

J Int Med Res 2022 Jun;50(6):3000605221105160

Department of Pathology, Minhang Hospital, Fudan University, Shanghai, P. R. China.

Pneumatosis cystoides intestinalis (PCI) is a rare disease that most frequently occurs in the large and small intestine and has no obvious clinical symptoms. The main pathological feature is the presence of air-filled cysts in the intestinal submucosa, intermuscular wall, and subserous membrane. Conservative treatment is the first choice when no serious complications are present, whereas timely surgical treatment is needed for serious and life-threatening complications. Read More

Nutrition 2022 Apr 11;101:111685. Epub 2022 Apr 11.

Department of Gastrointestinal Surgery, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong Province, China.

Hepatic portal venous gas (HPVG) is a rare and severe imaging manifestation for surgeons, and it may require emergency surgery. We report an unusual case of HPVG in association with the drip rate of enteral nutrition (EN) after laparoscopic-assisted radical total gastrectomy with Roux-en-Y reconstruction. A 66-year-old woman with gastric cancer was admitted to our hospital. Read More

Radiol Case Rep 2022 Jul 20;17(7):2568-2572. Epub 2022 May 20.

Department of Radiological Sciences, Oncology and Pathology, "Sapienza" University of Rome - I.C.O.T. Hospital, Via Franco Faggiana, 1668, 04100, Latina, Italy.

Acute Mesenteric Ischemia (AMI) is a rare life-threatening entity caused by sudden interruption of the blood supply to a segment of the bowel due to impairment of mesenteric arterial blood flow or venous drainage. Clinical presentation varies according to the time course of vascular occlusion. Contrast-enhanced Computed Tomography (CT) of the abdomen represents the main diagnostic test for AMI diagnosis, enabling fast and excellent evaluation of the intestine, mesenteric vasculature, and other ancillary characteristics of AMI. Read More

Cureus 2022 Apr 20;14(4):e24313. Epub 2022 Apr 20.

School of Medicine, Universidade Para o Desenvolvimento do Alto Vale do Itajaí, Rio do Sul, BRA.

Hepatic portal venous gas (HPVG) is a condition where air embolization from disrupted intestinal mucosa reaches the portal system. It is an uncommon finding and denotes severity. This report describes HPVG as a rare and lethal complication of enteral nutrition. Read More

Can Assoc Radiol J 2022 May 11:8465371221094280. Epub 2022 May 11.

Department of Diagnostic Radiology, 8664University of Manitoba, Winnipeg, MB, Canada.

Acute mesenteric ischemia (AMI) is an uncommon yet highly lethal cause of acute abdomen in the emergency setting. Computed tomography (CT) imaging, in particular a biphasic protocol consisting of angiographic and venous phase scans, is widely used to corroborate non-specific clinical findings when suspicions of AMI are high. Techniques such as low kilovoltage peak scanning, dual energy acquisition, or a combined arterial/enteric phase can improve iodine conspicuity and evaluation of bowel enhancement. Read More

Cir Esp (Engl Ed) 2022 05 22;100(5):304. Epub 2022 Apr 22.

Servicio de Cirugía General y del Aparato Digestivo, Hospital Virgen de las Nieves, Granada, Spain.

Case Rep Surg 2022 16;2022:2670244. Epub 2022 Apr 16.

Discipline of Surgery, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada A1B 3V6.

Introduction: Pneumatosis intestinalis (PI) is a condition of gas collection within the bowel wall that can represent either a benign clinical finding or a forerunner to potential gastrointestinal catastrophe. As a potentially sinister discovery typically first detected on radiographic imaging, clinicians need to astutely assess the need for additional urgent medical or surgical management in these patients. Apart from portal venous gas, PI outside of the bowel wall is an extremely rare entity that is poorly described. Read More

J Med Cases 2022 Apr 25;13(4):188-191. Epub 2022 Mar 25.

South East Regional Hospital, Bega, NSW, Australia.

Pneumatosis cystoides intestinalis (PCI) is an uncommon condition where cyst-like locules of gas are present in the submucosa or subserosa of the gastrointestinal tract. The majority of cases are benign and are associated with drugs such as chemotherapy agents or conditions including chronic obstructive airways disease. We present the case of PCI resulting in pneumoperitoneum in a 72-year-old male patient on chemotherapy for esophageal adenocarcinoma. Read More

BMC Gastroenterol 2022 Mar 28;22(1):150. Epub 2022 Mar 28.

Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, People's Republic of China.

Pneumatosis cystoides intestinalis (PCI) is a rare condition characterized by the presence of air collection within the subserosa and/or submucosa of the gastrointestinal wall. Due to the lack of specific symptoms, PCI is likely to be misdiagnosed or missed without the use of imaging techniques or gastrointestinal endoscopy. Here, we report a patient who complained of abdominal distention and constipation after chemotherapy for hematological malignancies, and was diagnosed with secondary PCI via computed tomography (CT) and exploratory laparotomy. Read More

N Engl J Med 2022 Mar 12;386(11):1070. Epub 2022 Mar 12.

Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

Insights Imaging 2022 Feb 22;13(1):25. Epub 2022 Feb 22.

Department of Radiology, University Hospitals Paris Nord Val-de-Seine, AP-HP, Beaujon, 92110, Clichy, France.

World J Surg 2022 04 6;46(4):784-790. Epub 2022 Feb 6.

Service de chirurgie digestive et cancérologique, CHU Nord Saint Etienne, Avenue Albert Raimond, 42270, Saint-Priest-en-Jarez, France.

Background: Gastric pneumatosis (GP) is a rare radiologic finding with an unpredictable prognosis. The aim of this study was to identify mortality risk factors from patients presenting with GP on computed tomography (CT), and to develop a model which would allow us to predict which patients would benefit most from operative management.

Methods: Between 2010 and 2020, all CT-scan reports in four tertiary centers were searched for the following terms: "gastric pneumatosis," "intramural gastric air" or "emphysematous gastritis. Read More

BMC Surg 2022 Jan 29;22(1):35. Epub 2022 Jan 29.

Department of Surgery, California Pacific Medical Center, San Francisco, CA, USA.

Background: Malrotation with bowel ischemia is classically thought of as a disease of infants. However, the true prevalence of malrotation in both the pediatric and adult population is unknown due to the unclear number of asymptomatic patients.

Case Presentation: A previously healthy 84-year-old man with no prior abdominal surgeries presented with an acute abdomen and was found on CT to have small bowel located in the right hemiabdomen and an abnormal SMA-SMV relationship suggestive of intestinal malrotation, as well as pneumatosis intestinalis. Read More

Br J Radiol 2022 Apr 27;95(1132):20211101. Epub 2022 Jan 27.

Department of Radiology, University of Florida College of Medicine, Gainesville, Florida, United States.

Objectives: Pneumatosis intestinalis is a radiographic finding that refers to the presence of gas within the walls of the small or large bowel. This sign is diagnostic in the setting of premature infants with suspected necrotizing enterocolitis. Earlier detection of NEC on X-ray is vital to improve the overall management in these infants. Read More

Medicine (Baltimore) 2022 Jan;101(3):e28588

Department of Gastroenterology, Affiliated Hospital & Clinical Medical College of Chengdu University, Chengdu, Sichuan, China.

Rationale: Pneumatosis cystoides intestinalis (PCI) is a rare condition characterized by multiple gas-filled cysts in the intestinal wall, and can be caused by many conditions.

Patient Concerns: We reported a-69-year-old man with a long history of chronic obstructive pulmonary disease was admitted to the gastroenterology department because of alternating bowel movement and intermittent bloody stool.

Diagnoses: Colonoscopy revealed multiple nodular protuberances covered with normal-looking mucosa in the ascending and proximal transverse colon. Read More

Abdom Radiol (NY) 2022 05 20;47(5):1625-1635. Epub 2022 Jan 20.

Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Raemistr. 100, 8091, Zürich, Switzerland.

Purpose: Pneumatosis intestinalis (PI) in the bowel wall demonstrated in computed tomography (CT) of the abdomen is unspecific and its prognostic relevance remains poorly understood. The purpose of this study was to identify predictors of short-term mortality in patients with suspected mesenteric ischemia who were referred to abdominal CT and showed PI.

Methods: In this retrospective, IRB-approved, single-centre study, CT scans and electronic medical records of 540 patients who were referred to abdominal CT with clinical suspicion of mesenteric ischemia were analysed. Read More

BMJ Case Rep 2022 01 19;15(1). Epub 2022 Jan 19.

Radiodiagnosis, Apollomedics Superspeciality Hospitals, Lucknow, Uttar Pradesh, India.

Br J Hosp Med (Lond) 2021 Dec 8;82(12). Epub 2021 Dec 8.

Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.

Am Surg 2022 May 4;88(5):1000-1002. Epub 2022 Jan 4.

1371Emory University School of Medicine, 71741Grady Memorial Hospital, Atlanta, GA, USA.

Graft versus host disease is a serious complication of allogenic stem cell transplants and can manifest with gastrointestinal complications including pneumatosis cystoides intestinali (PCI). A 43-year-old male with a history of acute myeloid leukemia presented to the hospital with abdominal pain and sepsis. The patient was intubated and admitted to the ICU. Read More

Pediatrics 2022 01;149(1 Suppl 1):S53-S58

Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia.

Context: Prior criteria to define pediatric multiple organ dysfunction syndrome (MODS) did not include gastrointestinal dysfunction.

Objectives: Our objective was to evaluate current evidence and to develop consensus criteria for gastrointestinal dysfunction in critically ill children.

Data Sources: Electronic searches of PubMed and EMBASE were conducted from January 1992 to January 2020, using medical subject heading terms and text words to define gastrointestinal dysfunction, pediatric critical illness, and outcomes. Read More

J Med Case Rep 2021 Dec 17;15(1):597. Epub 2021 Dec 17.

Department of Radiological Sciences, University of California Irvine, 101 The City Dr S Building 55, Suite 201, Orange, CA, 92868, USA.

Background: Pneumatosis cystoides intestinalis is a rare and usually benign condition in which multiple thin-walled cysts develop in the submucosa or subserosa of the gastrointestinal tract. While usually asymptomatic, severe cases can result in pneumoperitoneum, which can be managed surgically or medically depending on circumstances. We present a case of a patient with pneumatosis cystoides intestinalis, which presented as pneumoperitoneum following trauma. Read More

Rev Esp Enferm Dig 2022 04;114(4):238-239

Pediatric Surgery, Hospital General de Puebla "Dr. Eduardo Vázquez N".

A 4-month-old girl was admitted to the Emergency Department with gastric vomiting and bloody diarrhea. On physical examination, the abdomen was distended, painful, with evidence of peritoneal irritation. The abdominal X-ray showed the presence of intraluminal gas in the ascending colon, sigmoid and rectum. Read More

Pediatr Surg Int 2022 Mar 27;38(3):399-407. Epub 2021 Nov 27.

Division of Pediatric General, Thoracic and Fetal Surgery, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, USA.

Purpose: The significance and management of pediatric pneumatosis intestinalis (PI) remains poorly defined. We sought to add clarity in children beyond the neonatal period.

Methods: Pediatric patients 3 months-18 years admitted to a quaternary children's hospital with a diagnosis of PI were included in this retrospective study. Read More

BMJ Case Rep 2021 Nov 12;14(11). Epub 2021 Nov 12.

Surgery, Zuyderland Medical Centre Heerlen, Heerlen, Netherlands.

Pneumatosis intestinalis is described as gas within the bowel wall and can be a sign of bowel ischaemia with a pending perforation. The described patient presented with the incidental diagnosis of pneumatosis intestinalis with free intraperitoneal gas on CT scan. His medical history included a successful lung transplantation. Read More

J Med Case Rep 2021 Nov 12;15(1):556. Epub 2021 Nov 12.

Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Japan.

Background: Pneumatosis intestinalis is a rare disease characterized by gas-filled cysts within the submucosa or serosa of the intestinal tract. In recent years, pneumatosis intestinalis was reported in patients undergoing cancer treatment, and some case reports exist that report that pneumatosis intestinalis occurs during administration of vascular endothelial growth factor inhibitors, such as bevacizumab and sunitinib. Here, we report the first case of pneumatosis intestinalis during lenvatinib treatment. Read More

Urol Case Rep 2022 Jan 12;40:101895. Epub 2021 Oct 12.

Department of Urology, Thomas Jefferson University Hospital, Philadelphia, PA, 19107, USA.

Emphysematous pyelonephritis is a severe and rare gas producing infection in the renal parenchyma or collecting system. Diabetes mellitus is an established risk factor. Treatment options include antibiotics, minimally invasive management such as percutaneous drainage, or nephrectomy. Read More

Ann Med Surg (Lond) 2021 Nov 14;71:102924. Epub 2021 Oct 14.

Department of Surgery, Zuyderland Medisch Centrum, Heerlen, the Netherlands.

Introduction: and importance: The caesarean section is a widely spread procedure and 29.7 million times performed every year inn 169 countries in the world. Overall, complications are seen in 6% for elective caesarean to 15% for emergency caesarean. Read More

Ann Ital Chir 2021 Oct 25;10. Epub 2021 Oct 25.

Materials And Methods: We present here the case of an 83 y.o. male with intestinal perforation from pneumatosis cystoides intestinalis and consequent sepsis. Read More

Intensive Care Med 2022 Mar 20;48(3):358-359. Epub 2021 Oct 20.

Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.