Pneumatosis intestinalis in adults: management, surgical indications, and risk factors for mortality.

Pneumatosis intestinalis in adults: management, surgical indications, and risk factors for mortality. Research Abstract Details 

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Pneumatosis intestinalis in adults: management, surgical indications, and risk factors for mortality. Abstract Text:

Alexander J Greenstein,Scott Q Nguyen,Ana Berlin,Jacqueline Corona,Jonathan Lee,Everlyn Wong,Stephanie H Factor,Celia M Divino,Alexander J Greenstein,Scott Q Nguyen,Ana Berlin,Jacqueline Corona,Jonathan Lee,Everlyn Wong,Stephanie H Factor,Celia M Divino,

BACKGROUND : Pneumatosis intestinalis (PI) is an unusual finding that can exist in a benign setting but can indicate ischemic bowel and the need for surgical intervention. We present a series of cases of PI in adults to illustrate factors associated with death and surgical intervention. METHODS : We reviewed the radiology database of the Mount Sinai Medical Center for cases of PI between 1996-2006 in adult patients. Chi-square and multivariable logistic regression analyses were used to identify factors significant for surgery and death. RESULTS : Forty patients developed PI over a 10-year span. The overall in-hospital mortality rate was 20%, and the surgical rate was 35%. Factors independently associated with surgical management on multivariable analysis were age >or= 60 years (p = 0.03), the presence of emesis (p = 0.01), and a WBC > 12 c/mm3 (p = 0.03). Pre-existing sepsis was independently associated with mortality (p = 0.03) while controlling for surgery. CONCLUSION : Patients with the concomitant presence of PI, a WBC > 12 c/mm3, and/or emesis in the >60-year-old age group were most likely to have surgical intervention, whereas PI patients with sepsis had the highest risk for death. A management algorithm is proposed, but further research will be needed to determine which patients with PI may benefit most from surgery.

Pneumatosis intestinalis in adults: management, surgical indications, and risk factors for mortality. Publishing Authors By Initials

AJ Greenstein,SQ Nguyen,A Berlin,J Corona,J Lee,E Wong,SH Factor,CM Divino,AJ Greenstein,SQ Nguyen,A Berlin,J Corona,J Lee,E Wong,SH Factor,CM Divino,

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Pneumatosis intestinalis in adults: management, surgical indications, and risk factors for mortality. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Journal of gastrointestinal surgery : official jou

VOLUME: 11

Page Numbers: 1268-74

Journal Abbreviation: J. Gastrointest. Surg.

ISSN: 1091-255X

DAY: 9

MONTH: 08

YEAR: 2007

Pneumatosis intestinalis in adults: management, surgical indications, and risk factors for mortality. Information

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LANGUAGE: eng

NlmUniqueID: 9706084

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AFFILIATION: Department of Surgery, The Mount Sinai Medical Center, 5 E. 98th Street, 15th Floor, P.O. Box 1259, New York, NY 12029, USA.

Country: United States

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MEDLINETA: J Gastrointest Surg

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