Idiopathic pneumatosis intestinalis secondary to lactulose use in patients with cirrhosis. Issue 6 (9th December 2019)

• Record Type: Journal Article
• Authors: Varelas, Lee J; Klinge, Matthew J; Malik, Shahid M; Borhani, Amir A; Neal, Matthew
• Is Part Of: Journal of gastroenterology and hepatology. Volume 35:Issue 6(2020)
• Page Start: 1065
• Page End: 1068
• Publication Date: 2019-12-09
• Subjects: hepatic encephalopathy -- lactulose -- liver cirrhosis -- liver imaging -- pneumatosis intestinalis; Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Liver Diseases -- Periodicals; 616.33
• DOI: 10.1111/jgh.14920
• Languages: English
• ISSNs: 0815-9319

Abstract

Abstract: Background and Aim: Few case reports exist that link lactulose use with pneumatosis intestinalis in cirrhotics. This study investigates the relationship between lactulose use and idiopathic pneumatosis intestinalis in a cohort of cirrhotic patients. Methods: This case series considers several notable cases of patients with idiopathic pneumatosis intestinalis and concurrent lactulose use. Idiopathic pneumatosis intestinalis was defined as pneumatosis intestinalis with no identifiable etiology. A cohort of 119 patients with cirrhosis and pneumatosis intestinalis were identified in a tertiary care setting, via chart review by a multidisciplinary team. Eleven of these patients were found to have idiopathic pneumatosis intestinalis. Nine of these patients were being treated with lactulose. Results: Six out of 9 patients with idiopathic pneumatosis intestinalis that were being treated with lactulose saw resolution of pneumatosis intestinalis following discontinuation of treatment. Conclusions: The etiology of idiopathic pneumatosis intestinalis is likely multifactorial, but lactulose might play a preventable role in its formation.