Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center.
Department of Pediatrics, Cincinnati Children's Hospital Medical Center.
J Pediatr Gastroenterol Nutr. 2021 Oct 1;73(4):e87-e93. doi: 10.1097/MPG.0000000000003216.
Pneumatosis intestinalis (PI) is air collections within the wall of the intestine that can be associated with life threatening conditions. Recurrent episodes of PI have been reported; however, little is known about risks for recurrent disease. This study aims to identify predictors of recurrent PI and evaluate long-term outcomes in patients with recurrent PI.
This retrospective case-control study evaluated patients, ages 6 months to 18 years, with imaging evidence of PI over a 30-month period. Images were analyzed by consensus to confirm PI. Recurrent PI was defined as new findings of PI after resolution by imaging and/or at least 1-month interval between episodes of PI. Univariate and multivariable analyses were performed using logistic regression, with significance set to P < 0.05.
Forty-six children were included. Recurrent PI occurred in 17 (37%) patients, with a total of 39 episodes. Predictors of recurrent PI all related to the segment of bowel involved with small bowel PI predictive of recurrent PI (odds ratio [OR] 1.6; 95% confidence interval [CI] 1.01, 2.4) and colonic PI protective (OR 0.6; 95% CI 0.4, 0.87) after adjusting for age. Predictors for surgical intervention included cerebral palsy (OR 17; 95% CI 1.7, 167) and PI involving small bowel (OR 19; 95% 3.1, 114).
Location of PI is predictive of recurrence. Clinical outcomes were similar between groups with single episode and recurrent PI.
肠气肿（PI）是指肠壁内的气体积聚，可能与危及生命的情况有关。已有报道称该病会反复发作；然而，对于该病的复发风险，人们知之甚少。本研究旨在确定 PI 复发的预测因素，并评估 PI 复发患者的长期结局。
本回顾性病例对照研究评估了在 30 个月期间有影像学证据显示存在 PI 的 6 个月至 18 岁患者。通过共识分析图像以确认 PI。PI 复发定义为影像学缓解后新出现的 PI 表现和/或两次 PI 发作之间至少有 1 个月的间隔。使用逻辑回归进行单变量和多变量分析，以 P < 0.05 为显著性水平。
共纳入 46 例患儿。17 例（37%）患儿出现 PI 复发，共 39 次。PI 复发的预测因素均与受累肠段有关，小肠 PI （比值比 [OR] 1.6；95%置信区间 [CI] 1.01，2.4）与结肠 PI （OR 0.6；95% CI 0.4，0.87）有关，这些预测因素在调整年龄后仍有统计学意义。手术干预的预测因素包括脑瘫（OR 17；95% CI 1.7，167）和累及小肠的 PI（OR 19；95% CI 3.1，114）。
PI 的位置可预测其复发。单次发作和复发性 PI 患者的临床结局相似。
