Kim Jong Man, Park Yulri, Joh Jae-Won, Kwon Choon Hyuck David, Kim Sung Joo, Hong Seung Heui, Lee Suk-Koo
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Korean Surg Soc. 2011 Jun;80 Suppl 1(Suppl 1):S47-50. doi: 10.4174/jkss.2011.80.Suppl1.S47. Epub 2011 Jun 17.
Pneumatosis intestinalis is an uncommon disorder characterized by an accumulation of gas in the bowel wall. We described three cases undertaking liver transplantation. The patients developed diarrhea in three cases and high fever in two. An abdominal X-ray and computed tomography scan demonstrated extensive pneumatosis intestinalis in the colon with pneumoperitoneum mimicking hollow organ perforation. However, the patients had no abdominal symptoms and there was no evidence of peritonitis. The infection work-up was negative except one case with cytomegalovirus antigenemia. After one week of conservative management including bowel rest and antibiotic therapy, their pneumoperitoneum resolved spontaneously without any complication. Pneumatosis intestinalis should be considered as a differential diagnosis after adult liver transplantation with patients suffering from watery diarrhea and fever. Pneumoperitoneum, air-density in mesentery and retroperitoneum in patients with pneumatosis intestinalis without signs of peritonitis improved with conservative management, which included bowel rest and antibiotic therapy.
肠壁积气是一种罕见的疾病，其特征是肠壁内积聚气体。我们描述了3例接受肝移植的病例。3例患者出现腹泻，2例出现高热。腹部X线和计算机断层扫描显示结肠广泛存在肠壁积气并伴有气腹，类似中空器官穿孔。然而，患者没有腹部症状，也没有腹膜炎的证据。除1例巨细胞病毒抗原血症外，感染检查均为阴性。经过一周包括肠道休息和抗生素治疗在内的保守治疗，他们的气腹自行消退，没有任何并发症。对于成年肝移植后出现水样腹泻和发热的患者，应考虑将肠壁积气作为鉴别诊断。对于没有腹膜炎体征的肠壁积气患者，其气腹、肠系膜和腹膜后空气密度通过包括肠道休息和抗生素治疗在内的保守治疗得到改善。
