Pneumatosis intestinalis (also called intestinal pneumatosis, pneumatosis cystoides intestinalis, pneumatosis coli, or intramural bowel gas) is
pneumatosis
Pneumatosis is the abnormal presence of air or other gas within tissues.
In the lungs, emphysema involves enlargement of the distal airspaces, of an
intestine
The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organs of the digestive system, in humans ...
, that is, gas
cyst
A cyst is a closed sac, having a distinct envelope and cell division, division compared with the nearby Biological tissue, tissue. Hence, it is a cluster of Cell (biology), cells that have grouped together to form a sac (like the manner in which ...
s in the bowel wall.
As a
radiological sign
A radiologic sign is an objective indication of some medical fact (that is, a medical sign) that is detected by a physician during radiologic examination with medical imaging (for example, via an X-ray, CT scan, MRI scan, or sonographic scan). ...
it is highly suggestive for
necrotizing enterocolitis
Necrotizing enterocolitis (NEC) is a devastating intestinal disease that affects premature or very low birth weight infants.Gephart S.M., Quinn M. A call to action to fight for equity and end necrotizing enterocolitis disparities. ''Adv. Neonata ...
. This is in contrast to gas in the
intestinal lumen
The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organs of the digestive system, in humans ...
(which is relieved by
flatulence
Flatulence, in humans, is the expulsion of gas from the intestines via the anus, commonly referred to as farting. "Flatus" is the medical word for gas generated in the stomach or bowels. A proportion of intestinal gas may be swallowed environm ...
). In
newborns
An infant or baby is the very young offspring of human beings. ''Infant'' (from the Latin word ''infans'', meaning 'unable to speak' or 'speechless') is a formal or specialised synonym for the common term ''baby''. The terms may also be used to ...
, pneumatosis intestinalis is considered
diagnostic
Diagnosis is the identification of the nature and cause of a certain phenomenon. Diagnosis is used in many different disciplines, with variations in the use of logic, analytics, and experience, to determine " cause and effect". In systems engine ...
for necrotizing enterocolitis, and the gas is produced by bacteria in the bowel wall.
The pathogenesis of pneumatosis intestinalis is poorly understood and is likely multifactorial. PI itself is not a disease, but rather a clinical sign. In some cases, PI is an incidental finding, whereas in others, it portends a life-threatening intra-abdominal condition.
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Additional images
File:Pneumatosis intestinalis CT LF Darmischaemie cor.jpg, Pneumatosis intestinalis at computed tomography in intestinal ischemia. Lung window for better representation of the gas deposits in the intestinal walls. Coronal reconstruction.
File:Pneumatosis intestinalis CT LF cor.jpg, Pneumatosis intestinalis in the coronal computed tomography in lung window. It can be seen next to gas entrapment in the bowel wall and gas in the stomach wall and in numerous vessels, including the portal vein into the liver.
File:Pneumatosis intestinalis CT LF Darmischaemie.jpg, Pneumatosis intestinalis in computed tomography with intestinal ischemia. Lung window for better representation of the gas deposits in the intestinal walls.
File:Pneumatosis Intestinalis Radiograph.JPG, Upright AP radiograph showing gas in the wall of the small bowel in the left upper quadrant indicative of pneumatosis intestinalis.
File:Pneumatosis Intestinalis CT.JPG, Coronal reformatted MDCT image showing extensive pneumatosis intestinalis in the left upper quadrant small bowel. The pneumatosis is more cystic and nodular in the small bowel in the midline and the right of midline. This patient had a relatively benign presentation without bowel ischemia and was treated conservatively.
Image:Neonatal necrotizing enterocolitis, gross pathology 20G0022 lores.jpg, Alimentary tract of infant showing intestinal necrosis, pneumatosis intestinalis, and perforation site (arrow) (autopsy)
File:Pneumatosis cystoides intestinalis - low mag.jpg, Micrograph
A micrograph or photomicrograph is a photograph or digital image taken through a microscope or similar device to show a magnified image of an object. This is opposed to a macrograph or photomacrograph, an image which is also taken on a mic ...
showing large bowel wall with pneumatosis cystoides intestinalis, a generally benign subset of pneumatosis intestinalis. H&E stain
Hematoxylin and eosin stain ( or haematoxylin and eosin stain or hematoxylin-eosin stain; often abbreviated as H&E stain or HE stain) is one of the principal tissue stains used in histology. It is the most widely used stain in medical diagnos ...
.
References
External links
Gastrointestinal tract disorders
Radiologic signs
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