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Pneumatosis Intestinalis

Saima Siddiqui, MD Reviewed 06/2021
 


BASICS

DESCRIPTION

  • Air in the wall of the small or large intestine

  • Can occur in a variety of clinical settings, ranging from benign to life-threatening

  • Gas can be located in the mucosa, submucosa, and/or...

DIAGNOSIS

HISTORY

  • Symptoms—dependent on location (2)

    • Small intestine

      • Vomiting 60%

      • Abdominal distention 59%

      • Weight loss 55%

      • Abdominal pain 53%

      • Diarrhea 27%

    • Large intestine

      • Diarrhea 56%

      • Hematochezia 50%

      • Abdominal...

TREATMENT

GENERAL MEASURES

  • Primary PI can often be managed medically, whereas secondary PI typically requires surgical intervention. Surgery is reserved for patients who remain symptomatic despite medi...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Serial abdominal exams

  • For asymptomatic patients, follow-up imaging is not required.

  • Repeat imaging for recurrent symptoms.

DIET

  • A trial of an elemental diet for 2 we...

REFERENCES

1
Azami Y. Paralytic ileus accompanied by pneumatosis cystoides intestinalis after acarbose treatment in an elderly diabetic patient with a history of heavy intake of maltitol. Intern Med. 2...

ADDITIONAL READING

  • Di Pietropaolo M, Trinci M, Giangregorio C, Galluzzo M, Miele V. Pneumatosis cystoides intestinalis: case report and review of literature. Clin J Gastroenterol....

CODES

ICD10

K63.89 Other specified diseases of intestine 

SNOMED

17465007 pneumatosis cystoides intestinalis (disorder) 

CLINICAL PEARLS

  • PI is mostly an incidental, benign finding in adults.

  • It can be difficult to differentiate primary from secondary PI because they can present with similar symptoms.

  • Management of primary...

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