• Title/Summary/Keyword: Pneumatosis cystoides intestinalis

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Necrotizing enteritis with portal vein gas and pneumatosis cystoides intestinalis treated with delayed operation (지연 수술로 호전된 간문맥 내 가스와 장관 기종을 동반한 괴사성 장염)

  • Yoo, Ji Yeon;Yoo, Young Wook;Kim, Jihye;Yoo, Sang Hoon;Ha, Soyoung
    • Journal of Yeungnam Medical Science
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    • v.32 no.1
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    • pp.13-16
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    • 2015
  • Portal vein gas and pneumatosis cystoides intestinalis are uncommon conditions and have been associated with poor prognosis. They are most commonly caused by necrotizing enterocolitis but may have other causes, and they can be associated with necrotizing and ischemic colitis, intra-abdominal abscess, small bowel obstruction, diverticulitis, colon cancer, and acute pancreatitis. With the more frequent use of computed tomography (CT) scans, portal vein gas and pneumatosis cystoides intestinalis have been increasingly detected in recent years. Because of its high mortality rate, necrotizing enteritis with portal vein gas and pneumatosis cystoides intestinalis may be treated with emergent exploratory laparotomy. We report a case of necrotizing enteritis with portal vein gas and pneumatosis cystoides intestinalis in a 47-year-old man treated with intensive medical management and delayed operation due to unstable condition and surgical mortality. He had good clinical results without complications after the delayed operation.

Pneumatosis Cystoides Intestinales and Portomesenteric Venous Gas following Anticholinesterase Pesticide Poisoning (항콜린에스테라아제 살충제 음독 후 발생한 창자벽공기낭증과 문맥장간막정맥가스 1례)

  • Lee, Suk Hee;Lee, Kyung-Woo;Jung, Jin Hee
    • Journal of The Korean Society of Clinical Toxicology
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    • v.15 no.1
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    • pp.56-59
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    • 2017
  • Pneumatosis cystoides intestinalis and portomesenteric venous gas are uncommon radiological findings, but are found commonly in cases of bowel ischemia, or as a result of various non-ischemic conditions. A 72-year-old man visited an emergency center with altered mental status 2 hours after ingestion of an unknown pesticide. On physical examination, he showed the characteristic hydrocarbon or garlic-like odor, miotic pupils with no response to light, rhinorrhea, shallow respiration, bronchorrhea, and sweating over his face, chest and abdomen. Laboratory results revealed decreased serum cholinesterase, as well as elevated amylase and lipase level. We made the clinical diagnosis of organophosphate poisoning in this patient based on the clinical features, duration of symptoms and signs, and level of serum cholinesterase. Activated charcoal, fluid, and antidotes were administered after gastric lavage. A computerized tomography scan of the abdomen with intravenous contrast showed acute pancreatitis, poor enhancement of the small bowel, pneumatosis cystoides intestinalis, portomesenteric venous gas and ascites. Emergent laparotomy could not be performed because of his poor physical condition and refusal of treatment by his family. The possible mechanisms were believed to be direct intestinal mucosal damage by pancreatic enzymes and secondary mucosal disruption due to bowel ischemia caused by shock and the use of inotropics. Physicians should be warned about the possibility of pneumatosis cystoides intestinalis and portomesenteric venous gas as a complication of pancreatitis following anticholinesterase poisoning.

Pneumatosis Intestinalis Complicated by Pneumoperitoneum in a Patient with Asthma

  • Choi, Joon Young;Cho, Sung Bae;Kim, Hyun Ho;Lee, In Hee;Lee, Hea Yon;Kang, Hye Seon;Lee, Hwa Young;Lee, Sook Young
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.5
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    • pp.219-222
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    • 2014
  • Pneumatosis intestinalis (PI) is a very rare condition that is defined as the presence of gas within the subserosal or submucosal layer of the bowel. PI has been described in association with a variety of conditions including gastrointestinal tract disorders, pulmonary diseases, connective tissue disorders, organ transplantation, leukemia, and various immunodeficiency states. We report a rare case of a 74-year-old woman who complained of dyspnea during the management of acute asthma exacerbation and developed PI; but, it improved without any treatment.