Pneumatosis intestinalis (PI) is a condition in which multiple gas-filled cysts form within the wall of the gastrointestinal tract in either the subserosa or submucosa. The presence of pneumoperitoneum in the presence of PI can present a therapeutic dilemma. The aim of our study was to review our experience and management of this condition. A single-center retrospective study of consecutive children (> 1 year) presenting with a pneumoperitoneum and evidence of PI (2009-2015). Demographics, case notes, microbiology, and imaging were reviewed. Seven patients were identified (four males; age range 5-14 years). Four children had global developmental delay and were percutaneous endoscopic gastrostomy or jejunostomy fed, one was immunocompromised (acute lymphoblastic leukemia). The others had encephalitis and eosinophilic gastroenteritis. One patient proceeded to an exploratory laparotomy; no perforation was identified, pneumatosis of the colon was observed, and a loop ileostomy was formed. The remaining six were managed conservatively and made nil by mouth with intravenous antibiotics commenced. Five of the six had a computed tomography (CT) scan which revealed PI and free air with no other worrying signs. One died from nongastrointestinal causes, while the remaining five had feeds reintroduced uneventfully. Free air in the setting of PI may represent rupture of the gas cysts and not always transmural perforation. Surgery may not always be indicated and conservative management may suffice. A CT scan can be useful for excluding other intra-abdominal pathological findings and continued clinical assessment is essential.
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http://dx.doi.org/10.1055/s-0036-1587335 | DOI Listing |
J Formos Med Assoc
December 2024
Division of Colorectal Surgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, 100225, Taiwan. Electronic address:
Background: Surgical smoke generated by energy devices poses health risks to medical staff. During laparoscopic surgery, the smoke aggregating around the camera obstructs the visual field, forcing surgeons to interrupt surgery, and may increase surgical risk. We propose a proximal smoke evacuation method to improve surgical quality by effectively eliminating surgical smoke.
View Article and Find Full Text PDFJ Minim Access Surg
November 2024
Department of Surgery, ASCOMS, Jammu, Jammu and Kashmir, India.
Introduction: Inguinal hernia surgery, a common procedure worldwide, continues to develop to achieve minimal access and tension-free repairs. However, a universally accepted technique has yet to be developed. Our study introduces a new approach, a modified tumescent transabdominal pre-peritoneal (TAPP), to a low-cost setting.
View Article and Find Full Text PDFClin Imaging
January 2025
Keck School of Medicine of University of Southern California, Los Angeles, CA, United States of America; Department of Radiology, Cedars Sinai Hospital, Los Angeles, CA, United States of America. Electronic address:
Accurate image interpretation is essential in the field of radiology to the healthcare team in order to provide optimal patient care. This article discusses the use of artificial intelligence (AI) confidence levels to enhance the accuracy and dependability of its radiological diagnoses. The current advances in AI technologies have changed how radiologists and clinicians make the diagnoses of pathological conditions such as aneurysms, hemorrhages, pneumothorax, pneumoperitoneum, and particularly fractures.
View Article and Find Full Text PDFDiagnostics (Basel)
October 2024
Department of Anaesthesia and Intensive Care, Medical School, University of Pécs, 7624 Pécs, Hungary.
Background/objectives: Surgical pneumoperitoneum (PP) significantly impacts volume-controlled ventilation, characterized by reduced respiratory compliance, elevated peak inspiratory pressure, and an accelerated expiratory phase due to an earlier onset of the airway pressure gradient. We hypothesized that this would shorten expiratory time, potentially increasing expiratory flow rate compared to pneumoperitoneum conditions. Calculations were performed to establish correlations between respiratory parameters and the mean increase in expiratory flow rate relative to baseline.
View Article and Find Full Text PDFJ Anaesthesiol Clin Pharmacol
March 2024
Department of Pathology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
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