Pneumatosis intestinalis
Under pneumatosis intestinalis is a rare disease or in the radiology department is called a rare finding in medicine. The disease is characterized by an accumulation of gas in the wall ( intramural ) of the digestive tract. The gas accumulation may occur in different layers of the digestive organs. There is a distinction subserosal ( beneath the serosa ) of a submucosal ( beneath the mucosa ) pneumatosis intestinalis. In addition, can take place a classification according to the organs affected, for example, the intramural gas accumulation in the Dick intestine ( Colon ) is referred to as Pneumatosis coli. A special form is the pneumatosis cystoides intestinalis.
The first use of the term pneumatosis intestinalis goes back to Lerner and Gazin in 1946.
Pathogenesis
The emergence of pneumatosis intestinalis may have different causes. The mechanisms of how and when it comes to intramural gas accumulation are not yet fully understood. There are several possible explanations. The most common causes are the bowel necrosis due to a lack of oxygen (ischemia), necrotizing enterocolitis, volvulus, or sepsis. As mechanical causes, that is due to an increased intraluminal pressure are, for example, the stomach ulcer ( gastric ulcer ), the pyloric and the Annular pancreas in question. Even in immunosuppressed patients, pneumatosis intestinalis may form. It is believed that atrophy of the Peyer's patches - as a result of immunosuppression - is accompanied by a loss of integrity of the intestinal wall. Secondary could then lead to an inlet of gas into the intestinal wall.
Diagnosis and Therapy
The diagnosis is made with the help of imaging techniques. Pronounced intramural gas accumulations can already be diagnosed with a conventional radiograph of the abdomen ( Abdomenübersicht ). In geringgradig pronounced intramural gas accumulations or if the validity of the recording is reduced, for example by flatulence ( bloating ), the findings may lead to false positive. The diagnostic method of choice is now computed in the usually reliable delineation of intramural and extramural ( outside the walls) succeeds gas accumulation.
The treatment depends on the underlying cause or underlying disease.
Swell
- J. Trübenbach et al.: Cover picture: pneumatosis intestinalis RöFo 01/ 99 online version