Intestinal Research

Original Article

Inflammatory bowel diseases

Presentation and outcomes among inflammatory bowel disease patients with concurrent pneumatosis intestinalis: a case series and systematic review: Youran Gao, Meka Uffenheimer, Michael Ashamallah, Gregory Grimaldi, Arun Swaminath, Keith Sultan; Intest Res 2020;18(3):289-296. Published online November 4, 2019; DOI: https://doi.org/10.5217/ir.2019.00073

Background/Aims
Inflammatory bowel disease (IBD) involves chronic inflammation of the colon with ulcerative colitis (UC), and the colon and/or small intestine with Crohn’s disease (CD). Pneumatosis intestinalis (PI), characterized by compromise of the intestinal wall with gas-filled cysts, has rarely been reported with IBD. The presentation, best management and outcomes of PI with IBD are poorly defined.
Methods
We conducted a search for PI in all abdominal computed tomography (CT) reports at 2 large tertiary care hospitals from January 1, 2010 to December 31, 2017, cross referenced to ICD codes for IBD. CT and chart review was performed to confirm PI and IBD respectively. A systematic review excluding case reports was performed for PI with IBD for comparison.
Results
Of 5,990 patients with a CT abdomen report mentioning PI, we identified 11 cases of PI with IBD, 4 UC, 6 CD, and 1 indeterminate colitis. PI was limited to the small bowel in 5 patients, the right colon in 5, and small bowel and colonic in 1. All 3 mortalities had CD, small intestinal PI and portal/mesenteric venous gas. The systematic literature search identified 9 articles describing 58 patients with IBD and PI. These cases were mostly included in larger cohorts of PI patients without extractable data on presentation or outcomes in the IBD subpopulation.
Conclusions
Ours appears to be the first reporting of presentations and outcomes, outside of case reports, for those with PI and IBD. The high mortality for those with CD and PI of the small bowel appears to define a group requiring more than supportive medical care.

Citations

Citations to this article as recorded by

Teasing out factors differentiating pathologic from benign pneumatosis intestinalis
Julia Song, Biqi Zhang, David Mahvi, Mahsa Shariat, Manuel Castillo-Angeles, Tanujit Dey, Reza Askari
Journal of Trauma and Acute Care Surgery.2025; 98(5): 806. CrossRef
Pneumatosis Intestinalis in Adults
Jack Mather, Jose Diaz
Advances in Surgery.2025; 59(1): 143. CrossRef
Pneumatosis intestinalis presenting with acute abdomen
Cameron Fleming, Conor Joseph Hardacre, Ayaz Memon
BMJ Case Reports.2025; 18(7): e264888. CrossRef
MR Enterography in Ulcerative Colitis: Beyond Endoscopy
Amir Reza Radmard, Mehrnam Amouei, Ala Torabi, Ali Reza Sima, Hiva Saffar, Amine Geahchan, Amir H. Davarpanah, Bachir Taouli
RadioGraphics.2024;[Epub] CrossRef
Plaque-like Mucosal Change in Pneumatosis Intestinalis with Ulcerative Colitis
Atsushi Ikehata, Machi Kiyohara, Sadahide Ono, Takashi Kajiwara
Internal Medicine.2024; 63(17): 2467. CrossRef
The Challenge of Pneumatosis Intestinalis: A Contemporary Systematic Review
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Journal of Personalized Medicine.2024; 14(2): 167. CrossRef
Pneumatosis Intestinalis Manifesting as an Atypical Presentation of Crohn’s Disease
Charles Vallejo, Yousra Gheit, Talwinder K Nagi, Zoilo K Suarez, Muhammad Haider, Touqir Zahra
Cureus.2024;[Epub] CrossRef
The spectrum of pneumatosis intestinalis in the adult. A surgical dilemma
Giuseppe Tropeano, Marta Di Grezia, Caterina Puccioni, Valentina Bianchi, Gilda Pepe, Valeria Fico, Gaia Altieri, Giuseppe Brisinda
World Journal of Gastrointestinal Surgery.2023; 15(4): 553. CrossRef
Neumoperitoneo secundario a neumatosis intestinal masiva: un reporte de caso
David Charry-Borrero, Yesica Ascanio-Quintero, Juan Rodríguez-Valenzuela, Faure Yezid Rodríguez-Velásquez, Juan Felipe Coronado-Sarmiento, Eduardo Tuta-Quintero
Revista Colombiana de Cirugía.2023;[Epub] CrossRef
Idiopathic asymptomatic pneumoperitoneum in a patient with ureteric calculus and Crohn’s disease
Gitte Grunnet Raabe, Benedicte Schelde-Olesen, Thomas Bjørsum-Meyer
Journal of Surgical Case Reports.2022;[Epub] CrossRef
Pneumatosis Intestinalis Induced by Anticancer Treatment: A Systematic Review
Gianluca Gazzaniga, Federica Villa, Federica Tosi, Elio Gregory Pizzutilo, Stefano Colla, Stefano D’Onghia, Giusy Di Sanza, Giulia Fornasier, Michele Gringeri, Maria Victoria Lucatelli, Giulia Mosini, Arianna Pani, Salvatore Siena, Francesco Scaglione, An
Cancers.2022; 14(7): 1666. CrossRef
Pneumatosis Intestinalis Induced by Alpha-Glucosidase Inhibitors in Patients with Diabetes Mellitus
Blake J. McKinley, Mariangela Santiago, Christi Pak, Nataly Nguyen, Qing Zhong
Journal of Clinical Medicine.2022; 11(19): 5918. CrossRef

7,557 View
153 Download
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12 Crossref

Case Report

A Rare Case of Hypermobile Mesentery With Segmental Small Bowel Pneumatosis Cystoides Intestinalis: Chetan Rathi, Nirav Pipaliya, Prateik Poddar, Vikas Pandey, Meghraj Ingle, Prabha Sawant; Intest Res 2015;13(4):346-349. Published online October 15, 2015; DOI: https://doi.org/10.5217/ir.2015.13.4.346

Abstract PDF PubReader ePub

Pneumatosis intestinalis is a rare condition that affects 0.03% of the population. Pneumatosis cystoides intestinalis (PCI) is characterized by the presence of multiple gas-filled cysts in the intestinal wall and the submucosa and/or intestinal subserosa. It is usually a secondary finding caused by a wide variety of underlying gastrointestinal or extragastrointestinal diseases. Here, we present the case of a 47-year-old man who was referred to our gastroenterology department with a history suggestive of intermittent small bowel obstruction associated with abdominal pain. Abdominal computed tomography demonstrated PCI of the small bowel. The mesentery and branches of the superior mesenteric artery and superior mesenteric vein were twisted with minimal pneumoperitoneum. Exploratory laparotomy was performed, and demonstrated segmental small bowel PCI secondary to hypermobile mesentery. The affected segment of the ileum was resected, and jejunoileal anastomosis was performed. Here, we report a rare case of segmental PCI probably due to repeated twisting of hypermobile mesentery. The clinical and imaging features of this disorder may mimic those of visceral perforation or bowel ischemia. PCI can be a cause of severe abdominal pain that may require surgical intervention.

Citations

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Pneumatosis cystoides intestinalis presenting as pneumoperitoneum in a patient with chronic obstructive pulmonary disease
Genna Logue, Mubeen Chaudhry
BJR|case reports.2023;[Epub] CrossRef
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Journal of Surgical Case Reports.2022;[Epub] CrossRef
Portal vein gas combined with pneumatosis intestinalis and emphysematous cystitis: A case report and literature review
Shi-Fu Hu, Han-Bo Liu, Yuan-Yuan Hao
World Journal of Clinical Cases.2022; 10(25): 8945. CrossRef
Case Report: An unusual case of small bowel volvulus due to appendicitis associated with pneumatosis intestinalis: Review of the literature
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F1000Research.2022; 10: 951. CrossRef
Case Report: An unusual case of small bowel volvulus associated with pneumatosis intestinalis
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F1000Research.2021; 10: 951. CrossRef
Gastric Outlet Obstruction and Sigmoid Volvulus in a Patient with Pneumatosis intestinalis: An Etiology or a Complication
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Rapid reversal of colonic pneumatosis with restoration of mesenteric arterial supply
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Clinical Journal of Gastroenterology.2018; 11(6): 461. CrossRef

8,113 View
35 Download
6 Web of Science
7 Crossref

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