J Korean Radiol Soc.  2008 Feb;58(2):149-154. 10.3348/jkrs.2008.58.2.149.

Pneumatosis Intestinalis: CT Findings and Clinical Features

• Kim HL
• Lee HK
• Park SJ
• Yi BH
• Ko BM
• Hong HS
• Paik SH

• KMID: 2209118
• DOI: http://doi.org/10.3348/jkrs.2008.58.2.149

Abstract

PURPOSE: The purpose of this study is to evaluate the CT findings and clinical features of patients with pneumatosis intestinalis.
MATERIALS AND METHODS
From January 2001 to October 2007, 15 patients with pneumatosis intestinalis were diagnosed by the use of CT. We analyzed the clinical features and CT findings to assess the involvement site, the presence of portal and mesenteric vein gas, and the existence of accompanied ischemic change.
RESULTS
Of the 15 patients, five patients had end stage renal disease (33.3%), two patients underwent a gastrectomy, one patient underwent a laminectomy, one patient had tuberculous enteritis, one patient had lung cancer and one patient had pneumonia. Four patients presented with no specific disease. There was portal or mesenteric venous gas in six cases, and strangulation or an ischemic change of the bowel in five cases. Otherwise, pneumatosis intestinalis was associated with hydropneumoperitoneum in two cases, pneumoperitoneum in one case and a single case of perforated appendicitis. Nine patients underwent surgery for ischemic change of the bowel, hydropneumoperitoneum, appendicitis, and a clinical sign of panperitonitis. Among the remaining six patients, three patients recovered and were discharged, and three patients expired during progression of the disease.
CONCLUSION
End stage renal disease is the most common condition associated with pneumatosis intestinalis. The presence of portomesenteric venous gas, ischemic change of the bowel, and linear pneumatosis intestinalis are indicative of a poor prognosis.

Keyword

Pneumatosis cystoides intestinalis; Portal vein; Kidney failure; Computed tomography (CT)

MeSH Terms

Appendicitis
Enteritis
Gastrectomy
Humans
Kidney Failure, Chronic
Laminectomy
Lung Neoplasms
Mesenteric Veins
Pneumatosis Cystoides Intestinalis
Pneumonia
Pneumoperitoneum
Portal Vein
Prognosis
Renal Insufficiency