Clinical Predictors and Outcomes for Recurrent Pneumatosis Intestinalis in Children: A Case Control Study. Issue 4 (October 2021)

• Record Type: Journal Article
• Authors: Ta, Allison De Groot; Farrell, Michael; Dillman, Jonathan R.; Trout, Andrew T.
• Is Part Of: Journal of pediatric gastroenterology and nutrition. Volume 73:Issue 4(2021)
• Publication Date: 2021-10
• Subjects: imaging characteristics -- outcomes -- pediatrics -- pneumatosis -- surgery; Children -- Nutrition -- Periodicals; Pediatric gastroenterology -- Periodicals; Infants -- Nutrition -- Periodicals; Nutrition disorders in children -- Periodicals; Child Nutrition -- Periodicals; Digestive System -- growth & development -- Periodicals; Gastrointestinal Diseases -- Periodicals; Infant Nutrition -- Periodicals; Nutrition Disorders -- Periodicals; Child; 618.923
• DOI: 10.1097/MPG.0000000000003216
• Languages: English
• ISSNs: 0277-2116

Abstract

ABSTRACT: Introduction: 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. Methods: 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. Results: 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). Conclusion: Location of PI is predictive of recurrence. Clinical outcomes were similar between groups with single episode and recurrent PI. Abstract : Supplemental Digital Content is available in the text