Monday, November 9, 2009

Differentiating Benign and Clinically Worrisome Pneumatosis Intestinalis in Children

Pneumatosis intestinalis can have a benign or complicated course in children beyond the neonatal period. Benign cases are self-limited and can be managed conservatively. Benign causes of pneumatosis intestinalis include
  • Asthma
  • Bronchitis
  • Scleroderma
  • Systemic lupus erythematosus
  • AIDS
  • Postsurgical anastomosis
  • Endoscopy
  • Corticosteroids
  • Organ transplantation
CT can be used to suggest whether pneumatosis intestinalis reflects a benign or clinically worrisome cause.

CT Finding Benign Worrisome
Extensive involvement +  
Bowel wall thickening   +
Peri-bowel stranding   +
Free Fluid   +

The following CT findings are not helpful in differentiating benign and clinically worrisome cases of pneumatosis intestinalis in children:
  • Morphology of gas (cystic vs linear)
  • Distribution (small bowel, large bowel, or both)
  • Free peritoneal gas
  • Bowel dilatation
  • Small bowel obstruction
  • Portal venous gas


Olson DE, Kim YW, Ying J, Donnelly LF. CT predictors for differentiating benign and clinically worrisome pneumatosis intestinalis in children beyond the neonatal period. Radiology. 2009 Nov;253(2):513-9.

No comments:

Post a Comment

Note: Only a member of this blog may post a comment.