Case Report
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World J Radiol. Jun 28, 2010; 2(6): 233-236
Published online Jun 28, 2010. doi: 10.4329/wjr.v2.i6.233
Unusual radiological finding of lethal pneumatosis intestinalis and portomesenteric vein gas
Ioannis D Kyriazanos, Theodoros Α Bazinas, Grigorios G Tsoukalos, Christos N Stoidis
Ioannis D Kyriazanos, Christos N Stoidis, Department of Surgery, Athens Navy Hospital, 70 Deinokratous Street, 11521, Athens, Greece
Theodoros Α Bazinas, Department of Radiology, 251 Hellenic Airforce General Hospital, 3 P. Kanellopoulou Street, 11525, Athens, Greece
Grigorios G Tsoukalos, Department of Radiology, Athens Navy Hospital, 70 Deinokratous Street, 11521, Athens, Greece
Author contributions: Kyriazanos ID was the patients’ surgeon and was involved in drafting the manuscript and revising it critically for important intellectual content; Stoidis CN, Tsoukalos GG and Bazinas TA contributed to the study conception and design; Stoidis CN contributed to the analysis and interpretation of data and wrote the manuscript; all authors contributed equally to the final draft of the manuscript. all authors read and approved the final manuscript; Kyriazanos ID has given the final approval of the version to be published.
Correspondence to: Christos N Stoidis, MD, Department of Surgery, Athens Navy Hospital, 70 Deinokratous Street, 11521, Athens, Greece.
Telephone: +30-210-9235157 Fax: +30-2310-643149
Received: May 18, 2010
Revised: June 1, 2010
Accepted: June 8, 2010
Published online: June 28, 2010

Pneumatosis intestinalis and portomesenteric vein gas are rare and potentially severe radiological findings that occur both in pediatric and adult populations. They actually are radiographic signs of underlying intra-abdominal pathology, abnormality or diagnostic medical interference. If combined with other radiological or clinical signs of intestinal ischemia or sepsis, the prognosis is dismal and urgent laparotomy is mandatory. We report two cases of surgical treatment with ominous outcome in an effort to characterize this finding correctly as an absolute surgical indication or as an additional diagnostic criterion that simply marks a further breakdown of the systems in patients with a long list of severe medical conditions.

Keywords: Pneumatosis intestinalis, Portomesenteric vein gas, Intestinal obstruction, Intestinal ischemia, Surgery