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Pediatric Surgery International

Erschienen in:

27.11.2021 | Original Article

Pneumatosis intestinalis in children beyond the neonatal period: is it always benign?

verfasst von: Alexey Abramov, Valerie L. Luks, Felix De Bie, Rosa Hwang, Myron Allukian III, Gary W. Nace Jr.

Erschienen in: Pediatric Surgery International | Ausgabe 3/2022

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Abstract

Purpose

The significance and management of pediatric pneumatosis intestinalis (PI) remains poorly defined. We sought to add clarity in children beyond the neonatal period.

Methods

Pediatric patients 3 months–18 years admitted to a quaternary children’s hospital with a diagnosis of PI were included in this retrospective study. Pathologic PI was defined as irreversible, transmural intestinal ischemia.

Results

167 children were identified with PI. Of these children, 155 (92.8%) had benign PI and 12 (7.2%) developed pathologic PI. The most common underlying diagnosis for pathologic PI was global developmental delay (75%), although we identified a spectrum of underlying diagnoses at risk for PI. Physical exam notable for abdominal distension (p = 0.023) or guarding (p = 0.028), and imaging with portal venous gas (p < 0.001) or bowel distension (p = 0.001) were significantly associated with pathologic PI. Only 6.6% of all children underwent an operation. For those undergoing non-surgical management of benign PI, 75% of children received antibiotics and average duration of bowel rest was 6.8 days.

Conclusions

PI in children is primarily a benign phenomenon and often does not warrant surgical intervention. Bowel rest and antibiotics are therapeutic strategies frequently used in the treatment of this finding.

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Titel: Pneumatosis intestinalis in children beyond the neonatal period: is it always benign?
verfasst von: Alexey Abramov
Valerie L. Luks
Felix De Bie
Rosa Hwang
Myron Allukian III
Gary W. Nace Jr.
Publikationsdatum: 27.11.2021
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Surgery International / Ausgabe 3/2022
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-021-05048-0

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