The Challenge of Pneumatosis Intestinalis: A Contemporary Systematic Review
Pneumatosis intestinalis is a radiological finding with incompletely understood pathogenesis. To date, there are no protocols to guide surgical intervention. A systematic review of literature, according to PRISMA criteria, was performed. Medline and PubMed were consulted to identify articles reporti...
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| Veröffentlicht in: | Journal of personalized medicine 2024-01, Vol.14 (2), p.167 |
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| creator | Perrone, Gennaro Giuffrida, Mario Donato, Valentina Petracca, Gabriele Luciano Rossi, Giorgio Franzini, Giacomo Cecconi, Sara Annicchiarico, Alfredo Bonati, Elena Catena, Fausto |
| description | Pneumatosis intestinalis is a radiological finding with incompletely understood pathogenesis. To date, there are no protocols to guide surgical intervention.
A systematic review of literature, according to PRISMA criteria, was performed. Medline and PubMed were consulted to identify articles reporting on the items "emergency surgery, pneumatosis coli, and pneumatosis intestinalis" from January 2010 up to March 2022. This study has not been registered in relevant databases.
A total of 1673 patients were included. The average age was 67.1 ± 17.6 years. The etiology was unknown in 802 (47.9%) patients. Hemodynamic instability (246/1673-14.7% of the patients) was associated with bowel ischemia, necrosis, or perforation (
= 0.019). Conservative management was performed in 824 (49.2%) patients. Surgery was performed 619 (36.9%) times, especially in unstable patients with bowel ischemia signs, lactate levels greater than 2 mmol/L, and PVG (
= 0.0026). In 155 cases, surgery was performed without pathological findings.
Many variables should be considered in the approach to patients with pneumatosis intestinalis. The challenge facing the surgeons is in truly identifying those who really would benefit and need surgical intervention. The watch and wait policy as a first step seems reasonable, reserving surgery only for patients who are unstable or with high suspicion of bowel ischemia, necrosis, or perforation. |
| doi_str_mv | 10.3390/jpm14020167 |
| format | Article |
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A systematic review of literature, according to PRISMA criteria, was performed. Medline and PubMed were consulted to identify articles reporting on the items "emergency surgery, pneumatosis coli, and pneumatosis intestinalis" from January 2010 up to March 2022. This study has not been registered in relevant databases.
A total of 1673 patients were included. The average age was 67.1 ± 17.6 years. The etiology was unknown in 802 (47.9%) patients. Hemodynamic instability (246/1673-14.7% of the patients) was associated with bowel ischemia, necrosis, or perforation (
= 0.019). Conservative management was performed in 824 (49.2%) patients. Surgery was performed 619 (36.9%) times, especially in unstable patients with bowel ischemia signs, lactate levels greater than 2 mmol/L, and PVG (
= 0.0026). In 155 cases, surgery was performed without pathological findings.
Many variables should be considered in the approach to patients with pneumatosis intestinalis. The challenge facing the surgeons is in truly identifying those who really would benefit and need surgical intervention. The watch and wait policy as a first step seems reasonable, reserving surgery only for patients who are unstable or with high suspicion of bowel ischemia, necrosis, or perforation.</description><identifier>ISSN: 2075-4426</identifier><identifier>EISSN: 2075-4426</identifier><identifier>DOI: 10.3390/jpm14020167</identifier><identifier>PMID: 38392601</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Abdomen ; Case reports ; Cohort analysis ; Colon ; Colonoscopy ; Diagnostic tests ; Disease ; Etiology ; Hemodynamics ; Intestinal obstruction ; Intestine ; Ischemia ; Lactates ; Laparoscopy ; Laparotomy ; Monoclonal antibodies ; Necrosis ; Surgery ; Systematic review</subject><ispartof>Journal of personalized medicine, 2024-01, Vol.14 (2), p.167</ispartof><rights>COPYRIGHT 2024 MDPI AG</rights><rights>2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c388t-3216f9ee237ec96a42cc1908091b5db25c042f1d55fb944101270ecf8136c2f93</citedby><cites>FETCH-LOGICAL-c388t-3216f9ee237ec96a42cc1908091b5db25c042f1d55fb944101270ecf8136c2f93</cites><orcidid>0000-0003-3882-776X ; 0000-0001-8335-3941 ; 0000-0001-6502-9195 ; 0000-0001-5558-9965</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38392601$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Perrone, Gennaro</creatorcontrib><creatorcontrib>Giuffrida, Mario</creatorcontrib><creatorcontrib>Donato, Valentina</creatorcontrib><creatorcontrib>Petracca, Gabriele Luciano</creatorcontrib><creatorcontrib>Rossi, Giorgio</creatorcontrib><creatorcontrib>Franzini, Giacomo</creatorcontrib><creatorcontrib>Cecconi, Sara</creatorcontrib><creatorcontrib>Annicchiarico, Alfredo</creatorcontrib><creatorcontrib>Bonati, Elena</creatorcontrib><creatorcontrib>Catena, Fausto</creatorcontrib><title>The Challenge of Pneumatosis Intestinalis: A Contemporary Systematic Review</title><title>Journal of personalized medicine</title><addtitle>J Pers Med</addtitle><description>Pneumatosis intestinalis is a radiological finding with incompletely understood pathogenesis. To date, there are no protocols to guide surgical intervention.
A systematic review of literature, according to PRISMA criteria, was performed. Medline and PubMed were consulted to identify articles reporting on the items "emergency surgery, pneumatosis coli, and pneumatosis intestinalis" from January 2010 up to March 2022. This study has not been registered in relevant databases.
A total of 1673 patients were included. The average age was 67.1 ± 17.6 years. The etiology was unknown in 802 (47.9%) patients. Hemodynamic instability (246/1673-14.7% of the patients) was associated with bowel ischemia, necrosis, or perforation (
= 0.019). Conservative management was performed in 824 (49.2%) patients. Surgery was performed 619 (36.9%) times, especially in unstable patients with bowel ischemia signs, lactate levels greater than 2 mmol/L, and PVG (
= 0.0026). In 155 cases, surgery was performed without pathological findings.
Many variables should be considered in the approach to patients with pneumatosis intestinalis. The challenge facing the surgeons is in truly identifying those who really would benefit and need surgical intervention. The watch and wait policy as a first step seems reasonable, reserving surgery only for patients who are unstable or with high suspicion of bowel ischemia, necrosis, or perforation.</description><subject>Abdomen</subject><subject>Case reports</subject><subject>Cohort analysis</subject><subject>Colon</subject><subject>Colonoscopy</subject><subject>Diagnostic tests</subject><subject>Disease</subject><subject>Etiology</subject><subject>Hemodynamics</subject><subject>Intestinal obstruction</subject><subject>Intestine</subject><subject>Ischemia</subject><subject>Lactates</subject><subject>Laparoscopy</subject><subject>Laparotomy</subject><subject>Monoclonal antibodies</subject><subject>Necrosis</subject><subject>Surgery</subject><subject>Systematic review</subject><issn>2075-4426</issn><issn>2075-4426</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNptkdtLwzAUxoMoTuaefJeCj9KZWy_xbQwvw4Gi87mk6cmW0Ta1aZX990Y2dYLJQ04Ov-_wcT6EzggeMybw1bqpCMcUkzg5QCcUJ1HIOY0P9-oBGjm3xv6kEaUxPkYDljLhK3KCHhYrCKYrWZZQLyGwOniqoa9kZ51xwazuwHWmlqVx18EkmFrfqBrbynYTvGyc_8jOqOAZ3g18nKIjLUsHo907RK-3N4vpfTh_vJtNJ_NQsTTtQkZJrAUAZQkoEUtOlSICp1iQPCpyGinMqSZFFOlccE4woQkGpVPCYkW1YEN0sZ3btPat9wazte1bb9JlVDAsIkJ5_EstZQmZqbXtWqkq41Q2SVKOOYlp5KnxP5S_BVRG2Rq08f0_gsutQLXWuRZ01rSm8vvICM6-Isn2IvH0-c5qn1dQ_LDfAbBPoKKDcA</recordid><startdate>20240101</startdate><enddate>20240101</enddate><creator>Perrone, Gennaro</creator><creator>Giuffrida, Mario</creator><creator>Donato, Valentina</creator><creator>Petracca, Gabriele Luciano</creator><creator>Rossi, Giorgio</creator><creator>Franzini, Giacomo</creator><creator>Cecconi, Sara</creator><creator>Annicchiarico, Alfredo</creator><creator>Bonati, Elena</creator><creator>Catena, Fausto</creator><general>MDPI AG</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>8FE</scope><scope>8FH</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>LK8</scope><scope>M7P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><orcidid>https://orcid.org/0000-0003-3882-776X</orcidid><orcidid>https://orcid.org/0000-0001-8335-3941</orcidid><orcidid>https://orcid.org/0000-0001-6502-9195</orcidid><orcidid>https://orcid.org/0000-0001-5558-9965</orcidid></search><sort><creationdate>20240101</creationdate><title>The Challenge of Pneumatosis Intestinalis: A Contemporary Systematic Review</title><author>Perrone, Gennaro ; 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To date, there are no protocols to guide surgical intervention.
A systematic review of literature, according to PRISMA criteria, was performed. Medline and PubMed were consulted to identify articles reporting on the items "emergency surgery, pneumatosis coli, and pneumatosis intestinalis" from January 2010 up to March 2022. This study has not been registered in relevant databases.
A total of 1673 patients were included. The average age was 67.1 ± 17.6 years. The etiology was unknown in 802 (47.9%) patients. Hemodynamic instability (246/1673-14.7% of the patients) was associated with bowel ischemia, necrosis, or perforation (
= 0.019). Conservative management was performed in 824 (49.2%) patients. Surgery was performed 619 (36.9%) times, especially in unstable patients with bowel ischemia signs, lactate levels greater than 2 mmol/L, and PVG (
= 0.0026). In 155 cases, surgery was performed without pathological findings.
Many variables should be considered in the approach to patients with pneumatosis intestinalis. The challenge facing the surgeons is in truly identifying those who really would benefit and need surgical intervention. The watch and wait policy as a first step seems reasonable, reserving surgery only for patients who are unstable or with high suspicion of bowel ischemia, necrosis, or perforation.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>38392601</pmid><doi>10.3390/jpm14020167</doi><orcidid>https://orcid.org/0000-0003-3882-776X</orcidid><orcidid>https://orcid.org/0000-0001-8335-3941</orcidid><orcidid>https://orcid.org/0000-0001-6502-9195</orcidid><orcidid>https://orcid.org/0000-0001-5558-9965</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of personalized medicine, 2024-01, Vol.14 (2), p.167 |
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| source | MDPI - Multidisciplinary Digital Publishing Institute; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; PubMed Central Open Access |
| subjects | Abdomen Case reports Cohort analysis Colon Colonoscopy Diagnostic tests Disease Etiology Hemodynamics Intestinal obstruction Intestine Ischemia Lactates Laparoscopy Laparotomy Monoclonal antibodies Necrosis Surgery Systematic review |
| title | The Challenge of Pneumatosis Intestinalis: A Contemporary Systematic Review |
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