Clinical significance of pneumatosis intestinalis - correlation of MDCT-findings with treatment and outcome.

Détails

Ressource 1Télécharger: 330_2016_Article_4348.pdf (1556.49 [Ko])
Etat: Public
Version: Final published version
ID Serval
serval:BIB_C190212AB925
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Clinical significance of pneumatosis intestinalis - correlation of MDCT-findings with treatment and outcome.
Périodique
European radiology
Auteur(s)
Treyaud M.O., Duran R., Zins M., Knebel J.F., Meuli R.A., Schmidt S.
ISSN
1432-1084 (Electronic)
ISSN-L
0938-7994
Statut éditorial
Publié
Date de publication
01/2017
Peer-reviewed
Oui
Volume
27
Numéro
1
Pages
70-79
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish

Résumé
To evaluate the clinical significance of pneumatosis intestinalis (PI) including the influence on treatment and outcome.
Two radiologists jointly reviewed MDCT-examinations of 149 consecutive emergency patients (53 women, mean age 64, range 21-95) with PI of the stomach (n = 4), small (n = 68) and/or large bowel (n = 96). PI extension, distribution and possibly associated porto-mesenteric venous gas (PMVG) were correlated with other MDCT-findings, risk factors, clinical management, laboratory, histopathology, final diagnosis and outcome.
The most frequent cause of PI was intestinal ischemia (n = 80,53.7 %), followed by infection (n = 18,12.1 %), obstructive (n = 12,8.1 %) and non-obstructive (n = 10,6.7 %) bowel dilatation, unknown aetiologies (n = 8,5.4 %), drugs (n = 8,5.4 %), inflammation (n = 7,4.7 %), and others (n = 6,4 %). Neither PI distribution nor extension significantly correlated with underlying ischemia. Overall mortality was 41.6 % (n = 62), mostly related to intestinal ischemia (p = 0.003). Associated PMVG significantly correlated with underlying ischemia (p = 0.009), as did the anatomical distribution of PMVG (p = 0.015). Decreased mural contrast-enhancement was the only other MDCT-feature significantly associated with ischemia (p p < 0.001). Elevated white blood count significantly correlated with ischemia (p = 0.03).
In emergency patients, ischemia remains the most common aetiology of PI, showing the highest mortality. PI with associated PMVG is an alerting sign. PI together with decreased mural contrast-enhancement indicates underlying ischemia.
• In emergency patients, PI may be caused by various disorders. • Intestinal ischemia remains the most common cause of PI in acute situations. • PI associated with decreased mural contrast-enhancement indicates acute intestinal ischemia. • PI associated with PMVG should alert the radiologist to possible underlying ischemia.

Mots-clé
Adult, Aged, Aged, 80 and over, Disease Management, Emergencies, Female, Humans, Male, Middle Aged, Multidetector Computed Tomography/methods, Pneumatosis Cystoides Intestinalis/diagnosis, Pneumatosis Cystoides Intestinalis/therapy, Young Adult
Pubmed
Open Access
Oui
Création de la notice
07/12/2016 16:15
Dernière modification de la notice
20/08/2019 15:36
Données d'usage