2023, Number 07
Intestinal pneumatosis in the adult: a radiological sign
Language: Spanish
References: 21
Page:
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ABSTRACT
Intestinal pneumatosis is defined as the presence of air within the bowel wall. This is a radiological sing rather than a clinical condition. Pneumatosis has a long medical story. First described as pneumatosis cystoid in 1730, its detection has been primarily favored by the widespread use of computed tomography over the past decades. It is found more frequently in the small intestine, and rarely in an extraintestinal location. Its estimated prevalence is 0.03% and is most commonly seen among the years of 40 and 50. Pneumatosis intestinalis can be classified into primary and secondary forms. The primary form consists of an idiopathic gas infiltration of the bowel wall that resembles a bunch of grapes, whereas, secondary forms are more frequent and associated to a wide range of pathological patterns such as inflammatory bowel diseases, malignancies, chemotherapy, immune deficiency status or medical maneuvers, but it is a sign mainly related to intestinal ischemia and necrosis, that has long been considered a medical emergency, especially if related to porto-mesenteric vein gas. In the secondary intestinal pneumatosis, the radiological appearances are more varied. It is better detected and evaluated with computed tomography, which is the gold standard technique to detect intestinal pneumatosis and should be used in adults in any case in which either X-rays or ultrasound raise the suspicion. The aim of this article is to determine the usefulness of the intestinal pneumatosis as a radiological sign, with particular attention to the physiopathology, classification and radiological diagnoses.REFERENCES
González-Olivares C, Palomera-Rico A, Romera-Pintor Blanca N, Sánchez-Aldehuelo R, Figueroa-Tubío A, García de la Filia I, et al. Pneumatosis intestinalis in Crohn’s disease. Gastroenterol Hepatol [Internet]. 2019 [citado el 25 febrero 2023];42(3):181–3. Disponible en: http://dx.doi.org/10.1016/j.gastrohep.2018.05.007
Vélez Páez JL, Mora Coello CL, Álava Muñoz WD, Proaño Constante MJ, Heredia Toledo ME, Aguayo Moscoso SX. Colitis isquémica y neumatosis intestinal en paciente con COVID-19: reporte de caso. Horiz Med [Internet]. 03 de diciembre, 2021 [citado el 25 febrero 2023];21(4): e1305. Disponible en:http://dx.doi.org/10.24265/horizmed.2021.v21n4.11
Zuluaga-Santamaría A, Universidad CES, Mejía-Restrepo J, Uribe-González R, Gutiérrez-Márquez C, Bustamante-Zuluaga S, et al. Neumatosis intestinal: ¿una urgencia abdominal?. CES Med [Internet]. 2017 [citado el 25 febrero 2023];31(1):110–8. Disponible en: http://dx.doi.org/10.21615/cesmedicina.31.1.11
Ferrada P, Dubose J. Neumatosis intestinal y su importancia para el cirujano. En Cameron JL, Cameron AM, eds. Terapias quirúrgicas actuales 13.ª edición [Internet]. España: Elsevier; 2021 [citado el 25 febrero 2023]; p. 350-325. Disponible en: https://www-clinicalkey-es.binasss.idm.oclc.org/#!/content/book/3-s2.0-B9788491137443000659?scrollTo=%23hl0000046
Tavakkoli A, Ashley SW, Zinner MJ. Intestino delgado. En Charles Brunicardi F, Andersen DK, Billiar TR, Dunn DL, Kao LS, Hunter JG, eds. Schwartz Principios de Cirugía, 11e [Internet]. McGraw Hill; 2020 [citado el 15 marzo 2023]. Disponible en: https://accessmedicina-mhmedical-com.binasss.idm.oclc.org/content.aspx?bookid=2958§ionid=250640924#250641304
Gan T, Mark B. Intestino Delgado. En Townsend CM, Daniel Beauchamp R, Mark Evers B, Mattox KL, eds. Sabiston Tratado de cirugía 21a Edición [Internet]. España: Elsevier; 2022 [citado el 15 marzo 2023]; p.1240-1300. Disponible en: https://www-clinicalkey-es.binasss.idm.oclc.org/#!/content/book/3-s2.0-B9788413821801000501?scrollTo=%23hl0002520
Reyes J, Fernández F. Otras enfermedades intestinales. En Von Domarus A, Farreras P, Rozman C, Cardellach F, a Nicolás JM, Cervera R eds. Farreras Rozman Medicina Interna 19a edición [Internet]. España: Elsevier. 2020 [citado el 15 marzo 2023]; p. 189-197. Disponible en: https://www-clinicalkey-es.binasss.idm.oclc.org/#!/content/book/3-s2.0-B9788491135456000247?scrollTo=%23hl0000377
Camargo González NE, Benavides González MA, Parra Medina R, Pérez Hernández CJ. Neumatosis quística intestinal en un adulto joven sin antecedentes clínicos: reporte de caso. Rev Colomb Gastroenterol [Internet]. 2021[citado el 15 marzo 2023];36(Supl. 1):47–51. Disponible en: http://dx.doi.org/10.22516/25007440.530
Lebert P, Ernst O, Zins M, Lanchou M, Nzamuche J, Vermersch M. Pneumatosis intestinalis and portal venous gas in mechanical small bowel obstruction: Is it worrisome?. Diagnostic and interventional imaging [Internet]. 2021 [citado el 15 marzo 2023];102(9):491-582. Disponible en: https://doi.org/10.1016/j.diii.2021.05.001
Belloch Ripollés V, Muñoz Núñez CF, Fontana Bellorín A, Batista Doménech A, Boukhoubza A, Parra Hernández M, et al. Valoración de la neumatosis intestinal como complicación del trasplante pulmonar. Radiología [Internet]. 2023 [citado el 15 marzo 2023];65:2. Disponible en: http://dx.doi.org/10.1016/j.rx.2023.01.006
Vezzetti R. Ruidos de tripas: neumatosis intestinal y enterocolitis necrosante. En. Vezzetti R, Carlson J, Pennington D, eds. Radiología pediátrica en urgencias [Internet]. España: Elsevier; 2022 [citado el 15 marzo 2023]:44-47. Disponible en: https://www-clinicalkey-es.binasss.idm.oclc.org/#!/content/book/3-s2.0-B9788413822945000109?scrollTo=%23hl0000059
Arroyave Guerrero YA, Ruiz Beltrán GH, Meza Cabrera M del M, Muñoz Ruiz EO, Muñoz Ordoñez GW. Neumatosis quística intestinal y peritoneal, causa de neumoperitoneo. Revisión de la literatura a propósito de un caso. Rev Colomb Cir [Internet]. 2020 [citado el 15 marzo 2023];35(1):93–9. Disponible en: http://dx.doi.org/10.30944/20117582.592