Conservative management of pneumatosis intestinalis Journal Article
| Authors: | Tchabo, N. E.; Grobmyer, S. R.; Jarnagin, W. R.; Chi, D. S. |
| Article Title: | Conservative management of pneumatosis intestinalis |
| Abstract: | Background. Pneumatosis intestinalis is a rare condition characterized by subserosal and submucosal gas-filled cysts in the gastrointestinal tract; it may be associated with bowel ischemia, perforation, and a high mortality rate. As a result, many authorities advocate an aggressive surgical approach in patients with pneumatosis intestinalis. Case. A 53-year-old female with recurrent, metastatic uterine leiomyosarcoma underwent resection of the pelvic recurrence, low anterior rectal resection with primary anastomosis, and partial hepatectomy for liver metastasis. Her postoperative course was notable for a small bowel obstruction and the finding of pneumatosis intestinalis on radiologic studies. The patient developed mild abdominal pain. She did not develop tenderness or fevers. She was managed with bowel rest, nasogastric tube decompression, total parenteral nutrition, and broad-spectrum antibiotics. The finding of pneumatosis intestinalis resolved over the ensuing 6 days. Her diet was slowly advanced, and she was discharged home in stable condition without further surgical intervention or recurrence of the obstruction or pneumatosis. Currently, her only evidence of disease is pulmonary metastases. Conclusions. In select patients, the outcome of a conservative approach to the management of pneumatosis intestinalis is not much different than surgical re-exploration for highly selected patients. The clinical condition of the patient, not solely the finding of pneumatosis intestinalis, should drive management in these cases. © 2005 Elsevier Inc. All rights reserved. |
| Keywords: | adult; treatment outcome; middle aged; antibiotic agent; disease course; case report; postoperative period; recurrent cancer; pelvis; metastasis; abdominal pain; fever; postoperative complications; liver metastasis; lung metastasis; diet; anti-bacterial agents; conservative treatment; ciprofloxacin; liver resection; radiography; hospital discharge; intestinal obstruction; leiomyosarcoma; metronidazole; uterine neoplasms; uterus myoma; small intestine obstruction; rectum resection; intubation, gastrointestinal; parenteral nutrition; decompression; nasogastric tube; pneumatosis intestinalis; pneumatosis cystoides intestinalis; rectum anastomosis; parenteral nutrition, total |
| Journal Title: | Gynecologic Oncology |
| Volume: | 99 |
| Issue: | 3 |
| ISSN: | 0090-8258 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2005-01-01 |
| Start Page: | 782 |
| End Page: | 784 |
| Language: | English |
| DOI: | 10.1016/j.ygyno.2005.08.008 |
| PUBMED: | 16169578 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 10" - "Export Date: 24 October 2012" - "CODEN: GYNOA" - "Source: Scopus" |
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