Pneumatosis intestinalis–A radiographic sign not to be missed in bowel ischaemia

Jamani, Nurjasmine Aida and Hassan, Radhiana (2024) Pneumatosis intestinalis–A radiographic sign not to be missed in bowel ischaemia. Virtual Journal of Emergency Medicine, 35. pp. 1-3. E-ISSN 2405-4690

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Abstract

Pneumatosis intestinalis (PI), formerly known as pneumatosis coli, is the radiographic finding of gas within the small and large intestines. Even though PI is uncommon, its presence may pose a challenge in managing it. PI can present in a wide range of pathologies; thus, it is not diagnostic of any certain condition.1 The pathogenesis of PI is poorly understood and may be multifac�torial.1,2 This finding can represent a range of pathologies, from life-threatening to benign conditions. Hence, the management depends on the cause itself. The cause of PI can be idiopathic or secondary, and various gastrointestinal and non-gastrointestinal causes can cause it.2 Patients with PI can be asymptomatic or may present with abdominal symptoms such as abdominal pain, obstruction, bleeding, or any symptoms due to the underlying pathology associated with PI.2 Com�plications of PI include volvulus, intussusception, small and large bowel obstruction, haematochezia and pneumoperitoneum. These omplica�tions occur in 3 % of patients.2 As PI is a radiographic finding, most are detected on plain abdominal radiographs in approximately two-thirds of affected patients. Intramural gas can be circular, curvilinear, and linear in radiographs, while in abdominal ultrasounds, it may be visible as high-amplitude gas echoes.3,4 Besides, it may also be discovered incidentally during endo�scopic screening procedures where cysts of varying sizes are present. It appears pale or bluish in colour and deflated when biopsied. The pres�ence of PI in imaging may need further evaluation, such as a computed tomography scan, to evaluate the diagnosis and underlying cause and to assess complications.2,3 PI management depends on the underlying cause, whether there is an emergent surgical abdominal or benign cause. The management ranges from urgent laparotomy to outpatient observation.4 Considering the variety of presentations of PI, it is of utmost importance that clinicians should be able to interpret radiographic findings with the clinical history and physical examination to ensure correct diagnosis is managed accordingly.

Item Type:	Article (Case Report)
Subjects:	R Medicine > R Medicine (General) R Medicine > RA Public aspects of medicine R Medicine > RZ Other systems of medicine
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine > Department of Family Medicine (Effective: 1st January 2011) Kulliyyah of Medicine > Department of Radiology
Depositing User:	SR NUR FARHANA LATFI
Date Deposited:	23 Apr 2024 14:59
Last Modified:	23 Apr 2024 15:35
URI:	http://irep.iium.edu.my/id/eprint/111868

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