Conservative management of pneumatosis intestinalis

Nana E. Tchabo, Stephen R. Grobmyer, William R. Jarnagin, Dennis S. Chi

Research output: Contribution to journalArticle

14 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)782-784
Number of pages3
JournalGynecologic Oncology
Volume99
Issue number3
DOIs
StatePublished - Dec 1 2005
Externally publishedYes

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Neoplasm Metastasis
Recurrence
Leiomyosarcoma
Total Parenteral Nutrition
Case Management
Hepatectomy
Decompression
Abdominal Pain
Lung Diseases
Gastrointestinal Tract
Cysts
Fever
Ischemia
Gases
Conservative Treatment
Anti-Bacterial Agents
Diet
Mortality
Liver

All Science Journal Classification (ASJC) codes

  • Oncology
  • Obstetrics and Gynecology

Cite this

Tchabo, Nana E. ; Grobmyer, Stephen R. ; Jarnagin, William R. ; Chi, Dennis S. / Conservative management of pneumatosis intestinalis. In: Gynecologic Oncology. 2005 ; Vol. 99, No. 3. pp. 782-784.
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Conservative management of pneumatosis intestinalis. / Tchabo, Nana E.; Grobmyer, Stephen R.; Jarnagin, William R.; Chi, Dennis S.

In: Gynecologic Oncology, Vol. 99, No. 3, 01.12.2005, p. 782-784.

Research output: Contribution to journalArticle

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