Pneumatosis Intestinalis and Portal Venous Gas Associated with Placement of a Balloon Foley Jejunostomy Feeding Tube.

2007 ◽  
Vol 20 (7) ◽  
pp. 21
Author(s):  
J. Moore
Keyword(s):  
Pneumatosis Intestinalis ◽  
Feeding Tube ◽  
Portal Venous Gas ◽  
Jejunostomy Feeding

scholarly journals A rare case of portal pneumatosis. What are the therapeutic resources?

2019 ◽  
Vol 2 (1) ◽  
pp. 15-16
Author(s):  
IULIAN SLAVU ◽  
Daniela Mihaila ◽  
Lucian Alecu
Keyword(s):  
Decompression Sickness ◽  
Stable Condition ◽  
Pneumatosis Intestinalis ◽  
Clinical State ◽  
Hepatic Portal Venous Gas ◽  
Severe Condition ◽  
Gastric Distention ◽  
Ischemic Bowel ◽  
Portal Venous Gas ◽  
Hepatic Portal

Hepatic portal vein gas was first describes in 1955 by Wolf and Evans. It is a rare and severe condition that in 80% of cases leads to patient’s death. Most common causes are :necrotizing enterocolitis, mesenteric ischemia, sepsis , intestinal perforation. A 73-year old male patient underwent an elective rectal amputation for anal adenocarcinoma, after radiotherapy.In the 12th postoperative day the clinical state of the patient degraded, with onset of acute abdominal pain and fever.A CT scan and ultrasound examination showed the presence of  hepatic portal venous gas with of pneumatosis intestinalis and an abcess in the pelvic region.Intraoperatively, two small perforations were found at the distal jejunun with no ischemia or necrosis. An ileostomy was performed, with drainage of the peritoneal cavity.Post-operatively the patient was stabilized and was eventually discharged in stable condition .The presence of hepatic portal venous gas with the  of pneumatosis intestinalis is most frequently associated with ischemic bowel, ileus, diverticulitis, gastric distention, inflammatory bowel disease (IBD), hypotension post dialysis treatment, decompression sickness, trauma and iatrogenic causes from instrumentation and recent surgery.

PS02.152: DEVELOPMENT OF INTESTINAL PNEUMATOSIS AND PORTAL VENOUS GAS AFTER ESOPHAGECTOMY IS NOT INDICATIVE OF ISCHEMIC BOWEL AND CAN BE SUCCESSFULLY MANAGED NON-OPERATIVELY

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 164-164
Author(s):  
Erin Gillaspie ◽  
Micheal Moynagh ◽  
Sameh Said ◽  
Mark Allen ◽  
Shanda Blackmon ◽  
...  
Keyword(s):  
Conflicts Of Interest ◽  
Case Series ◽  
Pneumatosis Intestinalis ◽  
Bowel Ischemia ◽  
Tube Placement ◽  
Jejunostomy Tube ◽  
Radiographic Findings ◽  
Intestinal Pneumatosis ◽  
Ischemic Bowel ◽  
Portal Venous Gas

Abstract Background Pneumatosis intestinalis has long been a marker of advanced bowel ischemia and prompts urgent laparotomy. In post-operative settings, the presence of pneumatosis represents a significant management dilemma. We share a case-series of post-esophagectomy patients with pneumatosis intestinalis and no corollary intra-abdominal pathologic findings on re-exploration. Methods January 2000 to December 2017, 1760 patients underwent Ivor-Lewis esophagectomy or gastrectomy with jejunostomy-tube placement. Charts were reviewed retrospectively to identify patients with pneumatosis intestinalis discovered in the post-operative period. Demographic data, operative details and postoperative course were reviewed including incidence and details of re-exploration. Results Eleven patients met inclusion criteria. Nine were male (81.8%) and mean age was 69 years. All patients had radiographic confirmation of pneumatosis intestinalis and in many cases portal venous gas (Figure 1). Clinical course was variable without discernable trends in vitals or laboratory values. Development of significant postoperative ileus along with delivery of enteral tube feeds through a jejunostomy tube preceded development of the pneumatosis in all patients. Nine patients were re-explored and none had evidence of bowel ischemia. Conclusion The finding of pneumatosis intestinalis in the post-operative setting can be alarming and pose a management dilemma. With the advent of improved and readily available imaging, there has been an increase in findings that have no corollary physical symptomatology. In this series of patients, despite dramatic radiographic findings, none had ischemic bowel. Pneumatosis intestinalis alone in patients who have undergone esophagectomy should not be considered an indication for emergency re-exploration. Disclosure All authors have declared no conflicts of interest.

scholarly journals Pneumoperitoneum, pneumatosis intestinalis and portal venous gas: Rare gastrostomy complications case report

2019 ◽  
Vol 58 ◽  
pp. 174-177 ◽  
Author(s):  
Carlos Jose Perez Rivera ◽  
Nathaly Alexandra Ramirez ◽  
Alejandro Gonzalez-Orozco ◽  
Isabella Caicedo ◽  
Paulo Cabrera
Keyword(s):  
Case Report ◽  
Pneumatosis Intestinalis ◽  
Portal Venous Gas ◽  
Gastrostomy Complications

Pneumatosis Intestinalis and Hepatic Portal Venous Gas Caused by Gastrointestinal Perforation With Amyloidosis

2008 ◽  
Vol 42 (6) ◽  
pp. 758-759 ◽  
Author(s):  
Aihiro Yamamoto ◽  
Yutaka Kawahito ◽  
Mikiko Niimi ◽  
Masatoshi Kadoya ◽  
Masahide Hamaguchi ◽  
...  
Keyword(s):  
Pneumatosis Intestinalis ◽  
Gastrointestinal Perforation ◽  
Hepatic Portal Venous Gas ◽  
Portal Venous Gas ◽  
Hepatic Portal

PWE-228 Patient and carer experiences of living with a jejunostomy feeding tube after surgery for oesophago-gastric cancer

Gut ◽  
2015 ◽  
Vol 64 (Suppl 1) ◽  
pp. A312.1-A312
Author(s):  
V Halliday ◽  
M Baker ◽  
A Thomas ◽  
D Bowrey
Keyword(s):  
Gastric Cancer ◽  
Feeding Tube ◽  
Jejunostomy Feeding

scholarly journals Atypical dysphagia with end-stage oesophageal disease 30 years post Angelchik device placement in a 72-year-old man

2020 ◽  
Vol 13 (1) ◽  
pp. e230736
Author(s):  
Mattan Arazi ◽  
Brian Vadasz ◽  
Benjamin Person ◽  
Ronen Galili ◽  
Jason Lefkowitz
Keyword(s):  
Feeding Tube ◽  
Definitive Diagnosis ◽  
Device Removal ◽  
Proximal Stomach ◽  
Device Placement ◽  
Thoracic Approach ◽  
Oesophageal Pathology ◽  
End Stage ◽  
Jejunostomy Feeding ◽  
Progressive Dysphagia

Here we describe an atypical presentation of progressive dysphagia in a 72-year-old man leading to frequent regurgitations over the course of 30 years. Investigations revealed a foreign body ring surrounding the proximal stomach and dilation of the oesophagus proximal to the gastro-oesophageal junction. An Angelchik device was extracted; however, the patient’s rapid deterioration prior to surgery, in addition to his severely dysfunctional oesophagus, required placement of a jejunostomy feeding tube. Device removal was complicated by prior abdominal surgery, necessitating a thoracic approach. This case offers guidance on the management of patients with Angelchik prostheses who develop similar complications, while drawing attention to the importance and difficulties of early, definitive diagnosis in oesophageal pathology such as achalasia and gastro-oesophageal reflux disease.

Pneumatosis Intestinalis in Patients Receiving Tube Feeds

2017 ◽  
Vol 83 (8) ◽  
pp. 825-831
Author(s):  
Alexander C. Cavalea ◽  
Robert E. Heidel ◽  
Brian J. Daley ◽  
Christy M. Lawson ◽  
Darrell A. Benton ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Tube Feeding ◽  
Pneumatosis Intestinalis ◽  
Bowel Function ◽  
Feeding Tube ◽  
Outcome Data ◽  
Free Fluid ◽  
Feeding Intolerance ◽  
Lactic Acidemia ◽  
Bowel Dilatation

Pneumatosis intestinalis (PI) identified on computed tomography (CT) suggests an underlying pathology including bowel ischemia. Patients receiving tube feeds can develop PI, potentially requiring surgical intervention. We identify clinical factors in PI to predict those that may be safe to observe versus those that need immediate intervention. We retrospectively reviewed patients from a single institution from 2008 to 2016 with CT findings of PI and an enteric feeding tube. Patients who had not received tube feeds within one week of the CT were excluded. We analyzed clinical, operative, and outcome data to differentiate benign from pathologic outcomes. P values < 0.05 were set as significant. Forty patients were identified. We classified 24 as benign (no intervention) and 16 as pathologic (requiring intervention). A pathologic outcome was demonstrated for free fluid on CT [odds ratio (OR) = 5.00, confidence interval (CI) 1.23-20.30, P = 0.03)], blood urea nitrogen (BUN) elevation (OR = 8.27, CI 1.53-44.62, P = 0.01), creatinine (Cr) elevation (OR = 5.00, CI 1.27-19.62, P = 0.02), BUN/Cr ratio >30 (OR = 8.57, CI 1.79-40.98, P = 0.006), and vomiting/ feeding intolerance (OR = 9.38, CI 1.64-53.62, P = 0.01). Bowel function within 24 hours of the CT, bowel dilatation (small ≥ 3 cm; large ≥6 cm), and lactic acidemia were not significant. Peritonitis was only seen in pathologic states, but this did not reach statistical significance (P = 0.06). This represents the largest single-center retrospective analysis of tube feeding-induced PI to date. The presence of free fluid on CT, BUN and Cr elevation, BUN/Cr >30, vomiting/feeding intolerance and peritonitis were predictive of a pathologic etiology of PI.

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