Wood B J, Kumar P N, Cooper C, Silverman P M, Zeman R K
Department of Radiology, Georgetown University Medical Center, Washington, DC 20007, USA.
AJR Am J Roentgenol. 1995 Dec;165(6):1387-90. doi: 10.2214/ajr.165.6.7484571.
The significance of pneumatosis intestinalis in adults with AIDS is unknown. Adults with AIDS are predisposed to pneumatosis intestinalis. The purpose of this study is to determine the clinical significance and to characterize the imaging appearance of this finding in patients with AIDS.
In just over 3 years at our institution, pneumatosis intestinalis in adults with AIDS was detected in six cases. Medical records of those cases were retrospectively analyzed for clinical history, laboratory data, and surgical and pathologic findings. CT scans and abdominal radiographs were analyzed for location and severity of pneumatosis, presence of portal venous gas, pneumoperitoneum, and cystic versus linear gas.
Five of the six patients with AIDS-associated pneumatosis intestinalis were managed conservatively or medically without surgical procedures and were discharged from the hospital with resolved or decreasing gastrointestinal complaints. The other patient underwent an exploratory laparotomy because of free intraperitoneal and retroperitoneal air; however, no bowel perforation was found at surgery.
Pneumatosis intestinalis is a late-stage phenomenon in adult patients with AIDS that characteristically involves the cecum or right colon. Pneumatosis in patients with AIDS may be an indolent abnormality and does not necessarily constitute a surgical emergency or a sign of impending bowel necrosis.
肠道积气在成年艾滋病患者中的意义尚不清楚。成年艾滋病患者易患肠道积气。本研究的目的是确定这一发现的临床意义，并描述艾滋病患者的影像学表现。
在我们机构的短短3年多时间里，检测到6例成年艾滋病患者出现肠道积气。对这些病例的病历进行回顾性分析，以了解临床病史、实验室数据以及手术和病理结果。分析CT扫描和腹部X线片，以了解肠道积气的位置和严重程度、门静脉积气、气腹以及囊性与线性气体的情况。
6例艾滋病相关肠道积气患者中有5例采用保守治疗或药物治疗，未进行手术，出院时胃肠道症状缓解或减轻。另1例患者因腹腔内和腹膜后游离气体接受了剖腹探查术；然而，手术中未发现肠穿孔。
肠道积气是成年艾滋病患者的晚期现象，典型地累及盲肠或右结肠。艾滋病患者的肠道积气可能是一种惰性异常，不一定构成外科急症或即将发生肠坏死的迹象。
