Objective: The incidence and significance of pneumatosis intestinalis (PI) in children with a diagnosis of intestinal failure is not well understood. The aim of this study was to identify clinical and anatomical factors associated with the imaging findings of PI in patients with intestinal failure.
Methods: We performed a retrospective review of all children with a diagnosis of intestinal failure at Children's Hospital Colorado between January 2019 and April 2022. Patients were stratified and compared based on the incidence of PI on abdominal imaging. Differences were compared using 2-sample Wilcoxon tests, chi-square, or Fisher exact tests.
Results: There were 111 patients identified with a diagnosis of intestinal failure and 30.6% (34) developed at least 1 instance of PI. There were no differences in etiology of intestinal failure or anatomy between those who developed PI and those who did not. Patients who developed PI, were less likely to be on total parental nutrition (60.6% vs 98.6%, P < 0.001) and more likely to be receiving any form of enteral feeds (87.9% vs 66.2%, P = 0.035) or tube feeds (75.8% vs 44.2%, P = 0.0045). Of the children with PI, 30.3% (10) were undergoing an enteral feed advancement at time of PI development. Three patients with PI underwent laparotomy for PI treatment, 2 of which were negative laparotomies.
Conclusions: The development of PI in children with intestinal failure is likely a benign finding. It is associated with enteral feeding and may be due to increased intestinal stress.
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http://dx.doi.org/10.1097/MPG.0000000000003737 | DOI Listing |
Cancers (Basel)
December 2024
Departments of Surgery, Surgical Oncology, University of Nebraska Medical Center, Omaha, NE 68198, USA.
Background: Patients with peritoneal carcinomatosis often experience intestinal failure throughout the course of their disease, and total parenteral nutrition (TPN) can be used as a temporary solution or as a bridge to definitive cytoreductive surgery. Guidelines for TPN are well established for inpatients and in 2014, guidelines were established for the initiation of TPN for outpatients in a home setting. However, the safety and efficacy of home start TPN in advanced oncology patients remain unknown.
View Article and Find Full Text PDFBiomol Biomed
December 2024
Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Severe acute pancreatitis (SAP) is one of the leading causes of hospital admissions for gastrointestinal diseases, with a rising incidence worldwide. Intestinal microbiota dysbiosis caused by SAP exacerbates systemic inflammatory response syndrome and organ dysfunction. Fecal microbiota transplantation (FMT) has emerged as a promising therapeutic option for gastrointestinal diseases.
View Article and Find Full Text PDFJ Med Case Rep
January 2025
Department of Surgery, University Hospital "Tsaritsa Joanna - ISUL", Medical University, Str. "Byalo More" No 8, Sofia, Bulgaria.
Background: McKittrick-Wheelock syndrome is an uncommon and severe disorder caused by large hypersecretory tumors located in the distal colorectal area. Excessive secretion from adenomas is an unusual clinical manifestation that leads to severe electrolyte and fluid depletion, subsequently resulting in kidney injury. Successful treatment relies on quick and cooperative decision-making for timely intervention.
View Article and Find Full Text PDFJ Pediatr Gastroenterol Nutr
January 2025
Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Objective: Intestinal transplantation (ITx) has become an accepted option for children with serious complications from intestinal failure and parenteral nutrition (PN) dependence. We aimed to assess long-term growth and nutritional outcomes in these patients. We also assessed factors influencing nutritional status and ability to wean off tube feedings (TFs) after ITx.
View Article and Find Full Text PDFJPEN J Parenter Enteral Nutr
January 2025
Department of Gastroenterology and Hepatology-Dietetics, Radboud university medical center, Nijmegen, The Netherlands.
Background: In patients with chronic intestinal failure, the content and type of parenteral nutrition are individually determined based on various factors, including body composition. In clinical practice, bioelectrical impedance analysis is used to assess body composition using standardized protocols. However, these protocols lack specific recommendations for patients receiving parenteral nutrition.
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