Than Van Sy, Nguyen Minh Duc, Gallon Arnaud, Pham Minh Thong, Nguyen Duy Hung, Boyer Louis, Le Thanh Dung
Department of Vascular Radiology, Hôpital Gabriel Montpied, CHU Clermont-Ferrand, 58 rue Montalembert, Clermont-Ferrand 63000, France.
Clermont-Ferrand Faculty of Medicine, UMR Auvergne CNRS 6284, 28 Place Henri Dunant, Clermont-Ferrand 63000, France.
Radiol Case Rep. 2020 Sep 24;15(11):2459-2463. doi: 10.1016/j.radcr.2020.09.034. eCollection 2020 Nov.
Pneumatosis intestinalis (PI) and pneumoperitoneum are commonly recognized as severe signs of gastrointestinal diseases that require emergency surgery. However, these symptoms can also be caused by benign conditions. We describe 4 cases of benign PI and pneumoperitoneum that were detected in different clinical situations (accidental discovery in bilan of aortic dissection (case #1), bilateral pulmonary embolism (case #2), overflow diarrhea due to fecal impaction (case #3), and in follow-up postbiliary digestive anastomosis surgery (case #4), which were addressed with exploratory surgery (case #1) or conservative treatment (the remaining cases), with favorable outcomes. Because PI and pneumoperitoneum can be associated with both life-threatening causes and benign conditions, treatment decisions should be based on the correspondence between clinical and paraclinical features, rather than imaging alone
肠壁积气（PI）和气腹通常被认为是需要紧急手术的胃肠道疾病的严重体征。然而，这些症状也可能由良性疾病引起。我们描述了4例在不同临床情况下发现的良性PI和气腹病例（主动脉夹层造影偶然发现（病例#1）、双侧肺栓塞（病例#2）、粪块嵌塞导致的溢流性腹泻（病例#3）以及胆肠消化吻合术后随访（病例#4）），其中病例#1采用了 exploratory surgery（探查性手术），其余病例采用保守治疗，均取得了良好效果。由于PI和气腹可能与危及生命的病因以及良性疾病相关，治疗决策应基于临床和辅助检查特征之间的对应关系，而不仅仅依靠影像学检查。
