The spectrum of pneumatosis intestinalis in the adult.A surgical dilemma  

作　　者：Giuseppe Tropeano Marta Di Grezia Caterina Puccioni Valentina Bianchi Gilda Pepe Valeria Fico Gaia Altieri Giuseppe Brisinda 

机构地区：[1]Emergency Surgery and Trauma Center,Fondazione Policlinico Universitario A Gemelli IRCCS,Rome 00168,Italy [2]Department of Surgery,UniversitàCattolica del Sacro Cuore,Rome 00168,Italy

出　　处：《World Journal of Gastrointestinal Surgery》2023年第4期553-565,共13页世界胃肠外科杂志（英文版）（电子版）

摘　　要：Pneumatosis intestinalis(PI) is a striking radiological diagnosis. Formerly a rare diagnostic finding, it is becoming more frequently diagnosed due to the wider availability and improvement of computed tomography scan imaging. Once associated only with poor outcome, its clinical and prognostic significance nowadays has to be cross-referenced to the nature of the underlying condition.Multiple mechanisms of pathogenesis have been debated and multiple causes have been detected during the years. All this contributes to creating a broad range of clinical and radiological presentations. The management of patients presenting PI is related to the determining cause if it is identified. Otherwise, in particular if an association with portal venous gas and/or pneumoperitoneum is present, the eventual decision between surgery and non-operative management is challenging,even for stable patients, since this clinical condition is traditionally associated to intestinal ischemia and consequently to pending clinical collapse if not treated.Considering the wide variety of origin and outcomes, PI still remains for surgeons a demanding clinical entity. The manuscript is an updated narrative review and gives some suggestions that may help make the decisional process easier,identifying patients who can benefit from surgical intervention and those who can benefit from non-operative management avoiding unnecessary procedures.

关 键 词：Pneumatosis intestinalis Risk factors Treatment Portal venous gas Portomesenteric pneumatosis 

分 类 号：R574[医药卫生—消化系统]