The Challenge of Pneumatosis Intestinalis: A Contemporary Systematic Review
Purpose: Pneumatosis intestinalis is a radiological finding with incompletely understood pathogenesis. To date, there are no protocols to guide surgical intervention. Methods: A systematic review of literature, according to PRISMA criteria, was performed. Medline and PubMed were consulted to identif...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-01-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/14/2/167 |
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| author | Gennaro Perrone Mario Giuffrida Valentina Donato Gabriele Luciano Petracca Giorgio Rossi Giacomo Franzini Sara Cecconi Alfredo Annicchiarico Elena Bonati Fausto Catena |
| author_facet | Gennaro Perrone Mario Giuffrida Valentina Donato Gabriele Luciano Petracca Giorgio Rossi Giacomo Franzini Sara Cecconi Alfredo Annicchiarico Elena Bonati Fausto Catena |
| author_sort | Gennaro Perrone |
| collection | DOAJ |
| description | Purpose: Pneumatosis intestinalis is a radiological finding with incompletely understood pathogenesis. To date, there are no protocols to guide surgical intervention. Methods: 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. Results: 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 (<i>p</i> = 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 (<i>p</i> = 0.0026). In 155 cases, surgery was performed without pathological findings. Conclusions: 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. |
| first_indexed | 2024-03-07T22:25:06Z |
| format | Article |
| id | doaj.art-c7fda854110a420f9ef520e12c3331df |
| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-07T22:25:06Z |
| publishDate | 2024-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-c7fda854110a420f9ef520e12c3331df2024-02-23T15:23:45ZengMDPI AGJournal of Personalized Medicine2075-44262024-01-0114216710.3390/jpm14020167The Challenge of Pneumatosis Intestinalis: A Contemporary Systematic ReviewGennaro Perrone0Mario Giuffrida1Valentina Donato2Gabriele Luciano Petracca3Giorgio Rossi4Giacomo Franzini5Sara Cecconi6Alfredo Annicchiarico7Elena Bonati8Fausto Catena9Department of Emergency Surgery, Maggiore Hospital, 43126 Parma, ItalyDepartment of General Surgery, Maggiore Hospital, 43126 Parma, ItalyDepartment of General Surgery, Maggiore Hospital, 43126 Parma, ItalyDepartment of Emergency Surgery, Maggiore Hospital, 43126 Parma, ItalyDepartment of Emergency Surgery, Maggiore Hospital, 43126 Parma, ItalyDepartment of Emergency Surgery, Maggiore Hospital, 43126 Parma, ItalyDepartment of General Surgery, Maggiore Hospital, 43126 Parma, ItalyDepartment of General Surgery, AUSL Parma, 43125 Parma, ItalyDepartment of Emergency Surgery, Maggiore Hospital, 43126 Parma, ItalyDepartment of Emergency and Trauma Surgey, Bufalini Trauma Center, 47023 Cesena, ItalyPurpose: Pneumatosis intestinalis is a radiological finding with incompletely understood pathogenesis. To date, there are no protocols to guide surgical intervention. Methods: 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. Results: 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 (<i>p</i> = 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 (<i>p</i> = 0.0026). In 155 cases, surgery was performed without pathological findings. Conclusions: 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.https://www.mdpi.com/2075-4426/14/2/167pneumatosis cystoides intestinalissurgeryemergencyportal vein gasradiology |
| spellingShingle | Gennaro Perrone Mario Giuffrida Valentina Donato Gabriele Luciano Petracca Giorgio Rossi Giacomo Franzini Sara Cecconi Alfredo Annicchiarico Elena Bonati Fausto Catena The Challenge of Pneumatosis Intestinalis: A Contemporary Systematic Review Journal of Personalized Medicine pneumatosis cystoides intestinalis surgery emergency portal vein gas radiology |
| title | The Challenge of Pneumatosis Intestinalis: A Contemporary Systematic Review |
| title_full | The Challenge of Pneumatosis Intestinalis: A Contemporary Systematic Review |
| title_fullStr | The Challenge of Pneumatosis Intestinalis: A Contemporary Systematic Review |
| title_full_unstemmed | The Challenge of Pneumatosis Intestinalis: A Contemporary Systematic Review |
| title_short | The Challenge of Pneumatosis Intestinalis: A Contemporary Systematic Review |
| title_sort | challenge of pneumatosis intestinalis a contemporary systematic review |
| topic | pneumatosis cystoides intestinalis surgery emergency portal vein gas radiology |
| url | https://www.mdpi.com/2075-4426/14/2/167 |
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