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Management of pneumatosis intestinalis in children over the age of 6 months: a conservative approach.
Nellihela, Leel; Mutalib, Mohamed; Thompson, David; Jochen, Kammermeier; Upadhyaya, Manasvi.
Afiliación
  • Nellihela L; Department of Paediatric Surgery, Evelina London Children's Hospital, London, UK.
  • Mutalib M; Department of Paediatric Gastroenterology, Evelina London Children's Hospital, London, UK.
  • Thompson D; Department of Paediatric Surgery, Evelina London Children's Hospital, London, UK.
  • Jochen K; Department of Paediatric Gastroenterology, Evelina London Children's Hospital, London, UK.
  • Upadhyaya M; Department of Paediatric Surgery, Evelina London Children's Hospital, London, UK.
Arch Dis Child ; 103(4): 352-355, 2018 04.
Article en En | MEDLINE | ID: mdl-28988213
BACKGROUND: Pneumatosis intestinalis (PI) is an uncommon and poorly understood condition. Although it can be an incidental finding in asymptomatic individuals, it can also be secondary to life-threatening bowel ischaemia and sepsis. In premature infants, it is a pathognomonic sign of necrotising enterocolitis. There is no consensus regarding management and long-term outcome of children with PI. AIM: Review of our experience of PI in children beyond the early infantile period. METHODS: Retrospective review of patient's records and radiological images from 2013 to 2015. RESULTS: Eighteen patients (three girls) had radiologically confirmed PI. The median age was 4.5 years (range 8 months-13 years). Background medical conditions (number): short bowel syndrome (one), congenital heart disease (two), sickle cell disease (one), epilepsy (three), cerebral palsy (six), myotonic dystrophy (four) and peroxisomal biogenesis defect (one).Six children (33%) presented with abdominal distension, four (22%) with abdominal pain, three (17%) with bilious vomiting, two (11%) with diarrhoea and one (6%) with rectal bleeding. Two (11%) were asymptomatic. One had air in portal vein and two had pneumoperitoneum.All patients with symptomatic PI were treated conservatively with successful outcome and complete resolution of PI. None required surgical intervention. CONCLUSION: PI in children who are not on chemotherapy or immunosuppressant appears to follow a benign course and is responsive to conservative management. In contrast to adults, portal venous gas and pneumoperitoneum do not predict the need for surgical intervention.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neumatosis Cistoide Intestinal / Tratamiento Conservador Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Idioma: En Revista: Arch Dis Child Año: 2018 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neumatosis Cistoide Intestinal / Tratamiento Conservador Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Idioma: En Revista: Arch Dis Child Año: 2018 Tipo del documento: Article Pais de publicación: Reino Unido