Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh School of Medicine.
Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
J Gastroenterol Hepatol. 2020 Jun;35(6):1065-1068. doi: 10.1111/jgh.14920. Epub 2019 Dec 9.
Few case reports exist that link lactulose use with pneumatosis intestinalis in cirrhotics. This study investigates the relationship between lactulose use and idiopathic pneumatosis intestinalis in a cohort of cirrhotic patients.
This case series considers several notable cases of patients with idiopathic pneumatosis intestinalis and concurrent lactulose use. Idiopathic pneumatosis intestinalis was defined as pneumatosis intestinalis with no identifiable etiology. A cohort of 119 patients with cirrhosis and pneumatosis intestinalis were identified in a tertiary care setting, via chart review by a multidisciplinary team. Eleven of these patients were found to have idiopathic pneumatosis intestinalis. Nine of these patients were being treated with lactulose.
Six out of 9 patients with idiopathic pneumatosis intestinalis that were being treated with lactulose saw resolution of pneumatosis intestinalis following discontinuation of treatment.
The etiology of idiopathic pneumatosis intestinalis is likely multifactorial, but lactulose might play a preventable role in its formation.
仅有少数病例报告将乳果糖的使用与肝硬化患者的肠气肿联系起来。本研究调查了乳果糖使用与肝硬化患者特发性肠气肿之间的关系。
本病例系列研究考虑了一些特发性肠气肿并同时使用乳果糖的患者的显著病例。特发性肠气肿的定义为无明确病因的肠气肿。通过多学科团队对三级护理环境中的 119 名肝硬化和肠气肿患者的图表审查，确定了特发性肠气肿的队列。在这 11 名患者中发现了 9 名患有特发性肠气肿。这些患者中有 9 人正在接受乳果糖治疗。
在接受乳果糖治疗的 9 名特发性肠气肿患者中，有 6 名患者在停止治疗后肠气肿得到缓解。
特发性肠气肿的病因可能是多因素的，但乳果糖可能在其形成中起可预防的作用。
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