1/123. Pneumatosis intestinalis in association with connective tissue disease.Pneumatosis intestinalis in association with connective tissue diseases is an unusual combination whose pathogenesis is not yet understood. Furthermore, steroid medication, often used to treat these diseases, may itself cause pneumatosis. Three cases of scleroderma, systemic lupus erythematosus, and amyloidosis in association with pneumatosis and without prior steroid therapy are presented. The small vessel occlusive pathologic processes in these diseases may cause focal areas of mucosal ischemia resulting in small, perhaps transient ulcerations that allow gas to enter the gut wall from the lumen.- - - - - - - - - - ranking = 1keywords = gas (Clic here for more details about this article) |
2/123. Massive pneumatosis intestinalis: CT diagnosis.pneumatosis cystoides intestinalis is a rare condition characterized by multiple subserosal or submucosal gas filled cysts within the wall of a segment of bowel. It is associated with numerous conditions, both intra and extraabdominal in nature. The condition may be asymptomatic or may present clinically as nausea, vomiting, diarrhea or other signs of intestinal obstruction. With rupture of the cysts, pneumoperitoneum may be a finding. In a patient with vague clinical presentation, this finding radiographically may lead to a clinical dilemma as many of these patients have comorbid conditions which are also associated with intestinal perforation. The authors present the case of a 47-year-old obese black female found to have massive pneumatosis intestinalis of the tranverse colon with a small amount of free intraperitoneal air. This case highlights the importance of recognizing pneumatosis intestinalis as a possible mimic of free intraabdominal air as well as a possible cause of benign pneumoperitoneum.- - - - - - - - - - ranking = 1keywords = gas (Clic here for more details about this article) |
3/123. The "circle sign": a new sonographic sign of pneumatosis intestinalis - clinical, pathologic and experimental findings.BACKGROUND: Pneumatosis intestinalis (PI) represents gas in the bowel wall. The appearance of PI using high-resolution ultrasound (HRUS) has not been well described. OBJECTIVE: The purpose of this report is to describe a new ultrasound sign of pneumatosis seen in three patients. This sign, called the "circle sign", is indicative of bubbles of gas within the circumference of the bowel, producing an appearance of a continuous echogenic ring on ultrasound. Further studies of the sonographic characteristics of pneumatosis were performed with an in vitro model. MATERIALS AND methods: HRUS was performed prospectively in three patients demonstrating extensive PI radiographically. The appearance of the gas was characterized and the behavior of the intramural bubbles was studied when the bowel was compressed with the ultrasound transducer. Either CT scan or pathologic correlation was obtained in all patients. Experimental models of PI using air injected into the wall of sausage casing were developed. RESULTS: The presence of echogenic gas bubbles within the circumference of the wall of the bowel seen with HRUS was shown to represent pneumatosis intestinalis at histologic examination or by CT scanning in the three study patients. in vitro studies confirmed the clinical impression that the use of compression is helpful in distinguishing intramural from intraluminal air. CONCLUSION: The presence of echogenic gas bubbles in the wall of the bowel, often seen as a circle within the circumference of the bowel, may be helpful in diagnosing PI on ultrasound using HRUS.- - - - - - - - - - ranking = 5keywords = gas (Clic here for more details about this article) |
4/123. Pneumatosis [correction of pneumocystis] cystoides intestinalis with pneumoperitoneum and pneumoretroperitoneum in a patient with extensive chronic graft-versus-host disease.pneumatosis cystoides intestinalis is a rare finding of intramural gasfilled cysts in the bowel wall and sometimes free air in the abdomen. A few conditions are reported to cause this disease, one of them being immunosuppression. We describe a 50-year-old Caucasian male with extensive chronic graft-versus-host disease (GVHD) of the gut and skin who developed PCI with pneumoperitoneum and pneumoretroperitoneum. To our knowledge, this is the first report of PCI occurring in a patient with active chronic GVHD which resolved spontaneously.- - - - - - - - - - ranking = 1keywords = gas (Clic here for more details about this article) |
5/123. Pneumatosis intestinalis complicating C. difficile pseudomembranous colitis.Pneumatosis intestinalis (PI) is characterized by multiple gas-filled cysts or linear gas within the bowel wall. PI may be idiopathic (15%) or secondary (85%) to a variety of disorders. We report here the first otherwise healthy adult with C. difficile infection complicated by PI and review the possible mechanisms of this previously unrecognized complication of pseudomembranous colitis. With treatment of the underlying infection, the PI resolved within 6 days of presentation.- - - - - - - - - - ranking = 2keywords = gas (Clic here for more details about this article) |
6/123. Necroqizing enterocolitis with pneumatosis intestinalis in systemic lupus erythematosus and polyarteritis.Pneumatosis intestinalis was encountered in association with fatal necrotizing enterocolitis in systemic lupus erythematosus (SLE) and polyarteritis nodosa. The radiologic identification of mottled, bubbly, and linear collections of intramural intestinal gas distinguish this ominous complication from benign pneumatosis cystoides intestinalis. In the setting of intestinal vasculitis due to SLE or polyarteritis nodosa, these characteristic radiologic features indicate necrotizing enterocolitis. Since corticosteroids may mask clinical progression of the intestinal lesion, radiologic evaluation is essential in the overall management of the patient with intestinal vasculitis.- - - - - - - - - - ranking = 1keywords = gas (Clic here for more details about this article) |
7/123. A major advance in the management of pneumatosis coli.A new treatment for gas cysts of the large bowel is described which involves the continuous inhalation of a high concentration of oxygen over a five-day period. Two patients with incapacitating symptoms due to diffuse pneumatosis coli were treated by this method. oxygen therapy resulted in remission of symptoms and disappearance of cysts in both cases. The physiological basis of this simple, effective therapy is discussed, together with the precautions necessary in its use.- - - - - - - - - - ranking = 1keywords = gas (Clic here for more details about this article) |
8/123. Pneumatosis coli: an uncommon but treatable cause of faecal incontinence.Pneumatosis intestinalis is defined as the presence of gas within the bowel wall. Small bowel pneumatosis is less commonly reported and more severe than colonic disease in adults. Pneumatosis coli is characterised by multiple collections of encysted gas occurring within the sub-mucosa and subserosa of the colon and rectum. It is an uncommon condition which typically presents in late middle age and has been associated with a number of gastrointestinal (e.g. pyloric stenosis, sigmoid volvulus and ischaemic bowel) and non-gastrointestinal (e.g. chronic obstructive pulmonary disease, depression and multiple sclerosis) diseases. Some cases, however, are idiopathic or primary. Symptoms can include diarrhoea, constipation, mucus per rectum, bleeding, flatus, abdominal pain and, rarely, faecal incontinence. We report on two patients, one of whom presented with faecal incontinence, the other who had troublesome lower gastrointestinal symptoms including faecal incontinence. Both responded well to continuous oxygen therapy.- - - - - - - - - - ranking = 5keywords = gas (Clic here for more details about this article) |
9/123. pneumatosis cystoides intestinalis: an unexpected finding in intestinal bleeding under therapy with phenprocoumon.pneumatosis cystoides intestinalis is a rarely observed disorder on plain abdominal X-ray or colonoscopy examination. Although causing few complaints in adults, it can nevertheless lead to gastrointestinal bleeding. In the reported case, gastrointestinal bleeding was observed with coinciding pneumatosis and phenprocoumon therapy. After stopping anticoagulant therapy, pneumatosis vanished completely, thus suggesting that phenprocoumon is probably a further cause of the cystic disease. In the known list of drugs able to provoke pneumatosis, this case adds a new mechanism of affliction different to either immunosuppression or gas production.- - - - - - - - - - ranking = 3keywords = gas (Clic here for more details about this article) |
10/123. Sonographic detection of intestinal pneumatosis.Intestinal pneumatosis is an uncommon affection characterized by the presence of gas in the wall of the gastro-intestinal tract. The prognosis of this condition, observed in benign or severe diseases, is based on the outcome of the underlying affection. The diagnosis of pneumatosis intestinalis is unusually made with sonography. We report a case of pneumatosis intestinalis due to small bowel necrosis, initially suggested with sonography and further confirmed with computed tomography (CT) and pathology.- - - - - - - - - - ranking = 2keywords = gas (Clic here for more details about this article) |
| | Next -> |