Department of Surgery, Children's Hospital Colorado, 13123 E 16th Ave, Aurora, CO, 80045, USA.
Department of Cardiology, Children's Hospital Colorado, 13123 E 16th Ave, Aurora, CO, 80045, USA.
Pediatr Surg Int. 2022 Oct;38(10):1399-1404. doi: 10.1007/s00383-022-05171-6. Epub 2022 Jul 19.
Congenital heart disease (CHD) is a risk factor for the development of pneumatosis intestinalis (PI). Patients with single ventricle physiology (SVP) may be at higher risk of developing PI secondary to variations in systemic blood flow which affect bowel perfusion when compared to patients with biventricular physiology (BVP). We hypothesized that patients with SVP would have increased risk of recurrent PI.
A retrospective review was done from 10/2014 through 05/2020 with patients that met the following criteria: CHD, radiographic evidence of PI, and less than 1 year of age. Groups were divided based on ventricular physiology. Primary outcome was radiographic recurrence of PI and secondary outcomes were average antibiotic duration, NPO duration, median length of stay, need for GI operation, and death from PI.
A total of 51 patients were included, 34 with SVP and 17 with BVP. 26.47% of SVP had recurrence of PI whereas no BVP experienced a recurrence of PI. There was no significant difference in any of the secondary outcomes.
Our data suggest that patients with SVP are more likely to have recurrence of radiographic PI. We may need to consider patients with SVP that get PI as their own separate group.
先天性心脏病（CHD）是肠气肿（PI）发展的危险因素。与双心室生理（BVP）患者相比，单心室生理（SVP）患者的全身血流变化可能会影响肠灌注，因此发生 PI 的风险更高。我们假设 SVP 患者发生复发性 PI 的风险增加。
对 2014 年 10 月至 2020 年 5 月期间符合以下标准的患者进行回顾性研究：CHD、PI 的影像学证据以及年龄小于 1 岁。根据心室生理将患者分为两组。主要结局是影像学上 PI 的复发，次要结局是平均抗生素使用时间、禁食时间、中位住院时间、需要胃肠手术以及 PI 导致的死亡。
共纳入 51 例患者，其中 34 例为 SVP，17 例为 BVP。SVP 组中 26.47%的患者出现 PI 复发，而 BVP 组无一例出现 PI 复发。次要结局无显著差异。
我们的数据表明，SVP 患者更有可能出现影像学 PI 的复发。我们可能需要将 SVP 患者视为一个单独的群体。
