Factors associated with bowel necrosis in patients with hepatic portal venous gas and pneumatosis intestinalis
Aim Historically, the presence of hepatic portal venous gas (HPVG) and pneumatosis intestinalis (PI) have been reported to be associated with bowel necrosis and fatal outcome. However, there are no criteria to judge whether bowel necrosis has occurred. We aimed to examine the factors associated with...
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| Veröffentlicht in: | Acute medicine & surgery 2020-01, Vol.7 (1), p.e432-n/a |
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| creator | Muratsu, Arisa Muroya, Takashi Yui, Rintaro Nakamura, Fumiko Kishimoto, Masanobu Sakuramoto, Kazuhito Kuwagata, Yasuyuki |
| description | Aim
Historically, the presence of hepatic portal venous gas (HPVG) and pneumatosis intestinalis (PI) have been reported to be associated with bowel necrosis and fatal outcome. However, there are no criteria to judge whether bowel necrosis has occurred. We aimed to examine the factors associated with bowel necrosis in patients with HPVG and PI.
Methods
The study comprised 25 patients who were diagnosed as having HPVG and/or PI based on computed tomography (CT) findings in the Department of Emergency and Critical Care Medicine, Kansai Medical University Hospital (Osaka, Japan) between April 2013 and August 2017. We compared various factors, including clinical history, severity of present illness, laboratory data, and CT findings, and examined whether they were related to bowel necrosis.
Results
Both Sequential Organ Failure Assessment scores and total bilirubin levels were significantly higher in the necrosis group than those in the non‐necrosis group (P = 0.03 and P = 0.02, respectively). The quantity of portal venous gas observed on computed tomography was associated with bowel necrosis in patients with HPVG. In contrast, the presence of air‐type PI, defined as PI with emphysema covering the total circumference of the intestine in the absence of wall edema, and the presence of free air were significantly higher in the non‐necrosis group (both P |
| doi_str_mv | 10.1002/ams2.432 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6971442</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2474349507</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3922-3a3f35dcaae8bcba7ca33fd3465f9b830c69ac8b5c298ce76a97f903ca14f5bb3</originalsourceid><addsrcrecordid>eNp1kV9L3TAYh8OYTHHCPsEI7GY3dfnXprkZiOgUlF24XYe3aeqJtEmXpB789ks5Z84NvEpCnjz83vwQ-kDJKSWEfYEpsVPB2Rt0xEjNqral8u2L_SE6SemBEEIp4U1D36FDTlXbyro5Qv4STA4xYUgpGAfZ9njr8gZ3YWtH7K2JIbmEncczZGd9Trv7jV3PBs8hZhjxo_VhSfgeisn3ePZ2mSDvn2absvMwuvQeHQwwJnuyX4_Rz8uLH-dX1c33b9fnZzeV4YqxigMfeN0bANt2pgNpgPOh56KpB9W1nJhGgWm72jDVGisbUHJQhBugYqi7jh-jrzvvvHST7U3JHWHUc3QTxCcdwOl_b7zb6PvwqBslqRCsCD7vBTH8Wkp-Pblk7DiCt2VQzbiQNVGkWdFP_6EPYYll3EIJKbhQNZF_heuHpmiH5zCU6LVHvfaoS48F_fgy_DP4p7UCVDtg60b79KpIn93esVX4G8O9qls</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2474349507</pqid></control><display><type>article</type><title>Factors associated with bowel necrosis in patients with hepatic portal venous gas and pneumatosis intestinalis</title><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Access via Wiley Online Library</source><source>Wiley Online Library (Open Access Collection)</source><source>PubMed Central</source><creator>Muratsu, Arisa ; Muroya, Takashi ; Yui, Rintaro ; Nakamura, Fumiko ; Kishimoto, Masanobu ; Sakuramoto, Kazuhito ; Kuwagata, Yasuyuki</creator><creatorcontrib>Muratsu, Arisa ; Muroya, Takashi ; Yui, Rintaro ; Nakamura, Fumiko ; Kishimoto, Masanobu ; Sakuramoto, Kazuhito ; Kuwagata, Yasuyuki</creatorcontrib><description>Aim
Historically, the presence of hepatic portal venous gas (HPVG) and pneumatosis intestinalis (PI) have been reported to be associated with bowel necrosis and fatal outcome. However, there are no criteria to judge whether bowel necrosis has occurred. We aimed to examine the factors associated with bowel necrosis in patients with HPVG and PI.
Methods
The study comprised 25 patients who were diagnosed as having HPVG and/or PI based on computed tomography (CT) findings in the Department of Emergency and Critical Care Medicine, Kansai Medical University Hospital (Osaka, Japan) between April 2013 and August 2017. We compared various factors, including clinical history, severity of present illness, laboratory data, and CT findings, and examined whether they were related to bowel necrosis.
Results
Both Sequential Organ Failure Assessment scores and total bilirubin levels were significantly higher in the necrosis group than those in the non‐necrosis group (P = 0.03 and P = 0.02, respectively). The quantity of portal venous gas observed on computed tomography was associated with bowel necrosis in patients with HPVG. In contrast, the presence of air‐type PI, defined as PI with emphysema covering the total circumference of the intestine in the absence of wall edema, and the presence of free air were significantly higher in the non‐necrosis group (both P < 0.01).
Conclusions
This study showed that the quantity of HPVG was associated with bowel necrosis, whereas the presence of free air or air‐type PI was associated with non‐necrosis of the bowel.
The presence of free air or air‐type PI (air infiltration rush: emphysema completely covers the entire circumference of the intestine absent of wall edema) was associated with the absence of bowel necrosis in patients with HPVG/PI.</description><identifier>ISSN: 2052-8817</identifier><identifier>EISSN: 2052-8817</identifier><identifier>DOI: 10.1002/ams2.432</identifier><identifier>PMID: 31988756</identifier><language>eng</language><publisher>United States: John Wiley & Sons, Inc</publisher><subject>Abdomen ; Age ; Blood pressure ; Creatinine ; Critical care ; CT findings ; Dehydrogenases ; Edema ; Emphysema ; free air ; Glasgow Coma Scale ; Heart rate ; intestinal necrosis ; Laboratories ; Laparotomy ; Necrosis ; Original ; Pain ; SOFA score ; Veins & arteries</subject><ispartof>Acute medicine & surgery, 2020-01, Vol.7 (1), p.e432-n/a</ispartof><rights>2019 The Authors. published by John Wiley & Sons Australia, Ltd on behalf of Japanese Association for Acute Medicine</rights><rights>2019 The Authors. Acute Medicine & Surgery published by John Wiley & Sons Australia, Ltd on behalf of Japanese Association for Acute Medicine.</rights><rights>2020. This work is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). 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-c3922-3a3f35dcaae8bcba7ca33fd3465f9b830c69ac8b5c298ce76a97f903ca14f5bb3</citedby><cites>FETCH-LOGICAL-c3922-3a3f35dcaae8bcba7ca33fd3465f9b830c69ac8b5c298ce76a97f903ca14f5bb3</cites><orcidid>0000-0002-7035-7684 ; 0000-0002-3638-7708</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6971442/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6971442/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,865,886,1418,11567,27929,27930,45579,45580,46057,46481,53796,53798</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31988756$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Muratsu, Arisa</creatorcontrib><creatorcontrib>Muroya, Takashi</creatorcontrib><creatorcontrib>Yui, Rintaro</creatorcontrib><creatorcontrib>Nakamura, Fumiko</creatorcontrib><creatorcontrib>Kishimoto, Masanobu</creatorcontrib><creatorcontrib>Sakuramoto, Kazuhito</creatorcontrib><creatorcontrib>Kuwagata, Yasuyuki</creatorcontrib><title>Factors associated with bowel necrosis in patients with hepatic portal venous gas and pneumatosis intestinalis</title><title>Acute medicine & surgery</title><addtitle>Acute Med Surg</addtitle><description>Aim
Historically, the presence of hepatic portal venous gas (HPVG) and pneumatosis intestinalis (PI) have been reported to be associated with bowel necrosis and fatal outcome. However, there are no criteria to judge whether bowel necrosis has occurred. We aimed to examine the factors associated with bowel necrosis in patients with HPVG and PI.
Methods
The study comprised 25 patients who were diagnosed as having HPVG and/or PI based on computed tomography (CT) findings in the Department of Emergency and Critical Care Medicine, Kansai Medical University Hospital (Osaka, Japan) between April 2013 and August 2017. We compared various factors, including clinical history, severity of present illness, laboratory data, and CT findings, and examined whether they were related to bowel necrosis.
Results
Both Sequential Organ Failure Assessment scores and total bilirubin levels were significantly higher in the necrosis group than those in the non‐necrosis group (P = 0.03 and P = 0.02, respectively). The quantity of portal venous gas observed on computed tomography was associated with bowel necrosis in patients with HPVG. In contrast, the presence of air‐type PI, defined as PI with emphysema covering the total circumference of the intestine in the absence of wall edema, and the presence of free air were significantly higher in the non‐necrosis group (both P < 0.01).
Conclusions
This study showed that the quantity of HPVG was associated with bowel necrosis, whereas the presence of free air or air‐type PI was associated with non‐necrosis of the bowel.
The presence of free air or air‐type PI (air infiltration rush: emphysema completely covers the entire circumference of the intestine absent of wall edema) was associated with the absence of bowel necrosis in patients with HPVG/PI.</description><subject>Abdomen</subject><subject>Age</subject><subject>Blood pressure</subject><subject>Creatinine</subject><subject>Critical care</subject><subject>CT findings</subject><subject>Dehydrogenases</subject><subject>Edema</subject><subject>Emphysema</subject><subject>free air</subject><subject>Glasgow Coma Scale</subject><subject>Heart rate</subject><subject>intestinal necrosis</subject><subject>Laboratories</subject><subject>Laparotomy</subject><subject>Necrosis</subject><subject>Original</subject><subject>Pain</subject><subject>SOFA score</subject><subject>Veins & arteries</subject><issn>2052-8817</issn><issn>2052-8817</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNp1kV9L3TAYh8OYTHHCPsEI7GY3dfnXprkZiOgUlF24XYe3aeqJtEmXpB789ks5Z84NvEpCnjz83vwQ-kDJKSWEfYEpsVPB2Rt0xEjNqral8u2L_SE6SemBEEIp4U1D36FDTlXbyro5Qv4STA4xYUgpGAfZ9njr8gZ3YWtH7K2JIbmEncczZGd9Trv7jV3PBs8hZhjxo_VhSfgeisn3ePZ2mSDvn2absvMwuvQeHQwwJnuyX4_Rz8uLH-dX1c33b9fnZzeV4YqxigMfeN0bANt2pgNpgPOh56KpB9W1nJhGgWm72jDVGisbUHJQhBugYqi7jh-jrzvvvHST7U3JHWHUc3QTxCcdwOl_b7zb6PvwqBslqRCsCD7vBTH8Wkp-Pblk7DiCt2VQzbiQNVGkWdFP_6EPYYll3EIJKbhQNZF_heuHpmiH5zCU6LVHvfaoS48F_fgy_DP4p7UCVDtg60b79KpIn93esVX4G8O9qls</recordid><startdate>202001</startdate><enddate>202001</enddate><creator>Muratsu, Arisa</creator><creator>Muroya, Takashi</creator><creator>Yui, Rintaro</creator><creator>Nakamura, Fumiko</creator><creator>Kishimoto, Masanobu</creator><creator>Sakuramoto, Kazuhito</creator><creator>Kuwagata, Yasuyuki</creator><general>John Wiley & Sons, Inc</general><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>WIN</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-7035-7684</orcidid><orcidid>https://orcid.org/0000-0002-3638-7708</orcidid></search><sort><creationdate>202001</creationdate><title>Factors associated with bowel necrosis in patients with hepatic portal venous gas and pneumatosis intestinalis</title><author>Muratsu, Arisa ; Muroya, Takashi ; Yui, Rintaro ; Nakamura, Fumiko ; Kishimoto, Masanobu ; Sakuramoto, Kazuhito ; Kuwagata, Yasuyuki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3922-3a3f35dcaae8bcba7ca33fd3465f9b830c69ac8b5c298ce76a97f903ca14f5bb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Abdomen</topic><topic>Age</topic><topic>Blood pressure</topic><topic>Creatinine</topic><topic>Critical care</topic><topic>CT findings</topic><topic>Dehydrogenases</topic><topic>Edema</topic><topic>Emphysema</topic><topic>free air</topic><topic>Glasgow Coma Scale</topic><topic>Heart rate</topic><topic>intestinal necrosis</topic><topic>Laboratories</topic><topic>Laparotomy</topic><topic>Necrosis</topic><topic>Original</topic><topic>Pain</topic><topic>SOFA score</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Muratsu, Arisa</creatorcontrib><creatorcontrib>Muroya, Takashi</creatorcontrib><creatorcontrib>Yui, Rintaro</creatorcontrib><creatorcontrib>Nakamura, Fumiko</creatorcontrib><creatorcontrib>Kishimoto, Masanobu</creatorcontrib><creatorcontrib>Sakuramoto, Kazuhito</creatorcontrib><creatorcontrib>Kuwagata, Yasuyuki</creatorcontrib><collection>Wiley Online Library (Open Access Collection)</collection><collection>Wiley Online Library (Open Access Collection)</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Acute medicine & surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Muratsu, Arisa</au><au>Muroya, Takashi</au><au>Yui, Rintaro</au><au>Nakamura, Fumiko</au><au>Kishimoto, Masanobu</au><au>Sakuramoto, Kazuhito</au><au>Kuwagata, Yasuyuki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Factors associated with bowel necrosis in patients with hepatic portal venous gas and pneumatosis intestinalis</atitle><jtitle>Acute medicine & surgery</jtitle><addtitle>Acute Med Surg</addtitle><date>2020-01</date><risdate>2020</risdate><volume>7</volume><issue>1</issue><spage>e432</spage><epage>n/a</epage><pages>e432-n/a</pages><issn>2052-8817</issn><eissn>2052-8817</eissn><abstract>Aim
Historically, the presence of hepatic portal venous gas (HPVG) and pneumatosis intestinalis (PI) have been reported to be associated with bowel necrosis and fatal outcome. However, there are no criteria to judge whether bowel necrosis has occurred. We aimed to examine the factors associated with bowel necrosis in patients with HPVG and PI.
Methods
The study comprised 25 patients who were diagnosed as having HPVG and/or PI based on computed tomography (CT) findings in the Department of Emergency and Critical Care Medicine, Kansai Medical University Hospital (Osaka, Japan) between April 2013 and August 2017. We compared various factors, including clinical history, severity of present illness, laboratory data, and CT findings, and examined whether they were related to bowel necrosis.
Results
Both Sequential Organ Failure Assessment scores and total bilirubin levels were significantly higher in the necrosis group than those in the non‐necrosis group (P = 0.03 and P = 0.02, respectively). The quantity of portal venous gas observed on computed tomography was associated with bowel necrosis in patients with HPVG. In contrast, the presence of air‐type PI, defined as PI with emphysema covering the total circumference of the intestine in the absence of wall edema, and the presence of free air were significantly higher in the non‐necrosis group (both P < 0.01).
Conclusions
This study showed that the quantity of HPVG was associated with bowel necrosis, whereas the presence of free air or air‐type PI was associated with non‐necrosis of the bowel.
The presence of free air or air‐type PI (air infiltration rush: emphysema completely covers the entire circumference of the intestine absent of wall edema) was associated with the absence of bowel necrosis in patients with HPVG/PI.</abstract><cop>United States</cop><pub>John Wiley & Sons, Inc</pub><pmid>31988756</pmid><doi>10.1002/ams2.432</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-7035-7684</orcidid><orcidid>https://orcid.org/0000-0002-3638-7708</orcidid><oa>free_for_read</oa></addata></record> |
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| source | DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Access via Wiley Online Library; Wiley Online Library (Open Access Collection); PubMed Central |
| subjects | Abdomen Age Blood pressure Creatinine Critical care CT findings Dehydrogenases Edema Emphysema free air Glasgow Coma Scale Heart rate intestinal necrosis Laboratories Laparotomy Necrosis Original Pain SOFA score Veins & arteries |
| title | Factors associated with bowel necrosis in patients with hepatic portal venous gas and pneumatosis intestinalis |
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