Conservative versus Surgical Treatment of Pneumatosis Intestinalis: Experience from a Multidisciplinary Center

• DOI: 10.12659/ajcr.943166
• Publication Date: 2024-02-08T15:12:43Z
• Authors: Huy Duc Tran; Sang Thanh Tran; Triet Minh Le; Vinh Ngoc Truong ...; Kien Trung Le; An Trinh Ngoc Le; Viet Van Ung; Tan Danh Hoang; Thinh Huu Nguyen
• Keywords: Pneumatosis Intestinalis; Abdominal cavity

Objective:Rare disease Background:Pneumatosis intestinalis (PI) is an uncommon condition that not specific to any particular disease.Currently, there no clinical guideline for treating and diagnosing PI.Furthermore, are numerous causes of PI, which makes it difficult clinicians -internal medicine physicians as well surgeons -to take a approach diagnosis treatment. Case Reports:We present 3 scenarios with PI.In the first patient was solitary image treated successfully parenteral nutrition intravenous antibiotics, he discharged after 5 days.The other 2 cases, involve gas in hepatic portal vein (HPVG), were handled distinct ways: surgically conservatively.One needed diagnostic laparoscopy necrotic segmentectomy from hospital on postoperative day 16.The last patient, received resuscitation treatment due severe comorbidities inability tolerate surgery.After days, abdominal CT scan revealed signs remaining PI.However, terminally 7 weeks septic shock caused by sacrococcygeal ulcer urinary tract infection.By drawing comparisons among these scenarios, we aim highlight certain indicators conservative success. Conclusions:PI HPVG sign prognosis, often requires surgical intervention.However, decision manage conservatively or depends patient's criteria such peritonitis, free fluid cavity, presence shock.Physicians should also weigh benefits risks intervention critically ill patients.