Pneumatosis intestinalis and portal venous gas in mechanical small bowel obstruction: Is it worrisome? - 02/09/21
, Olivier Ernst a, Marc Zins b, Marie Lanchou a, Jean-Robert Nzamushe c, Mathilde Vermersch a
Bienvenue sur EM-consulte, la référence des professionnels de santé.
Article gratuit.
Connectez-vous pour en bénéficier!
Highlights |
• | Pneumatosis and portal venous gas are rarely encountered in mechanical small bowel obstruction. |
• | Pneumatosis and portal venous gas are not associated with permanent ischemia or resection. |
• | Pneumatosis and portal venous gas are rarely worrisome in mechanical small bowel obstruction. |
Abstract |
Purpose |
The purpose of this study was to evaluate the clinical significance of pneumatosis intestinalis (PI) and portal venous gas (PVG) in patients with mechanical small bowel obstruction (SBO), using surgical findings or clinical follow-up as standard of reference.
Materials and methods |
Fourteen patients with mechanical SBO associated with PI and PVG were retrospectively included. There were 7 men and 7 women with a mean age of 59±19 (SD) (range: 25–93 years). CT examinations were reviewed by two radiologists to confirm the diagnosis of mechanical SBO and make a description of PI. Interobserver agreement was calculated. The reference standard was intraoperative appearance of the bowel wall (10/14; 71%) or the recovery of a normal bowel function in patients who were managed conservatively (4/14; 29%).
Results |
Among the 10 patients who underwent surgery, a normal appearance of the bowel in association with PI on CT was found intraoperatively in 8/10 (80%) patients and a reversible ischemia in the remaining 2/10 (20%) patients. The four patients who were managed conservatively recovered normal bowel function. Two patients died within two weeks following SBO.
Conclusion |
PI and PVG are not specific signs of bowel necrosis in mechanical SBO.
Le texte complet de cet article est disponible en PDF.Keywords : Emergencies, Tomography, X-ray computed, Intestinal obstruction, Intestine, small, Ischemia
Abbreviations : CI, CT, PI, PVG, SBO, SD
Plan
Vol 102 - N° 9
P. 545-551 - septembre 2021 Retour au numéro
Article précédent
- CT-guided biopsy of lung nodules with pleural contact: Comparison of two puncture routes
- Toshihiro Iguchi, Takao Hiraki, Yusuke Matsui, Koji Tomita, Mayu Uka, Takashi Tanaka, Kazuaki Munetomo, Hideo Gobara, Susumu Kanazawa
- Instability of the extensor digitorum tendons in Jaccoud arthropathy assessed by semi-dynamic MRI of the metacarpophalangeal joints
- Thomas Kirchgesner, Maria Stoenoiu, Nicolas Michoux, Xavier Libouton, Frédéric Houssiau, Bruno Vande Berg
Bienvenue sur EM-consulte, la référence des professionnels de santé.