Clinical and CT features of benign pneumatosis intestinalis in pediatric hematopoietic stem cell transplant and oncology patients

M. Beth McCarville, Sarah B. Whittle, Geoffrey S. Goodin, Chin-Shang Li, Matthew P. Smeltzer, Gregory A. Hale, Robert A. Kaufman

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background: Pneumatosis intestinalis in children is associated with a wide variety of underlying conditions and often has a benign course. The CT features of this condition have not been systematically investigated. Objective: Defining benign pneumatosis intestinalis as pneumatosis intestinalis that resolved with medical management alone, we sought to: (1) determine whether the incidence of benign pneumatosis intestinalis had increased at our pediatric cancer hospital; (2) characterize CT features of benign pneumatosis intestinalis; and (3) determine the relationship between imaging features and clinical course of benign pneumatosis intestinalis in this cohort. Materials and methods: Radiology reports from November 1994 to December 2006 were searched for "pneumatosis intestinalis," "free intraperitoneal air," and "portal venous air or gas." Corresponding imaging was reviewed by two radiologists who confirmed pneumatosis intestinalis and recorded the presence of extraluminal free air, degree of intramural gaseous distension, number of involved bowel segments, and time to pneumatosis resolution. Results: The search revealed 12 boys and 4 girls with pneumatosis intestinalis; 11 were hematopoietic stem cell transplant recipients. The annual incidences of benign pneumatosis have not changed at our institution. Increases in intramural distension marginally correlated with the number of bowel segments involved (P=0.08). Three patients had free air and longer times to resolution of pneumatosis (P=0.03). Conclusion: Male children may be at increased risk of benign pneumatosis intestinalis. The incidence of benign pneumatosis at our institution is proportional to the number of hematopoietic stem cell transplants. The degree of intramural distension may correlate with the number of bowel segments involved. Patients with free air have a longer time to resolution of benign pneumatosis.

Original languageEnglish (US)
Pages (from-to)1074-1083
Number of pages10
JournalPediatric Radiology
Volume38
Issue number10
DOIs
StatePublished - Oct 2008
Externally publishedYes

Fingerprint

Hematopoietic Stem Cells
Air
Pediatrics
Transplants
Incidence
Cancer Care Facilities
Pediatric Hospitals
Radiology
Gases

Keywords

  • Cancer
  • Children
  • Hematopoietic stem cell transplant
  • Pneumatosis intestinalis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Pediatrics, Perinatology, and Child Health
  • Radiological and Ultrasound Technology

Cite this

Clinical and CT features of benign pneumatosis intestinalis in pediatric hematopoietic stem cell transplant and oncology patients. / McCarville, M. Beth; Whittle, Sarah B.; Goodin, Geoffrey S.; Li, Chin-Shang; Smeltzer, Matthew P.; Hale, Gregory A.; Kaufman, Robert A.

In: Pediatric Radiology, Vol. 38, No. 10, 10.2008, p. 1074-1083.

Research output: Contribution to journalArticle

McCarville, M. Beth ; Whittle, Sarah B. ; Goodin, Geoffrey S. ; Li, Chin-Shang ; Smeltzer, Matthew P. ; Hale, Gregory A. ; Kaufman, Robert A. / Clinical and CT features of benign pneumatosis intestinalis in pediatric hematopoietic stem cell transplant and oncology patients. In: Pediatric Radiology. 2008 ; Vol. 38, No. 10. pp. 1074-1083.
@article{c91da99d6c3b43cd9f127064f2a08cbf,
title = "Clinical and CT features of benign pneumatosis intestinalis in pediatric hematopoietic stem cell transplant and oncology patients",
abstract = "Background: Pneumatosis intestinalis in children is associated with a wide variety of underlying conditions and often has a benign course. The CT features of this condition have not been systematically investigated. Objective: Defining benign pneumatosis intestinalis as pneumatosis intestinalis that resolved with medical management alone, we sought to: (1) determine whether the incidence of benign pneumatosis intestinalis had increased at our pediatric cancer hospital; (2) characterize CT features of benign pneumatosis intestinalis; and (3) determine the relationship between imaging features and clinical course of benign pneumatosis intestinalis in this cohort. Materials and methods: Radiology reports from November 1994 to December 2006 were searched for {"}pneumatosis intestinalis,{"} {"}free intraperitoneal air,{"} and {"}portal venous air or gas.{"} Corresponding imaging was reviewed by two radiologists who confirmed pneumatosis intestinalis and recorded the presence of extraluminal free air, degree of intramural gaseous distension, number of involved bowel segments, and time to pneumatosis resolution. Results: The search revealed 12 boys and 4 girls with pneumatosis intestinalis; 11 were hematopoietic stem cell transplant recipients. The annual incidences of benign pneumatosis have not changed at our institution. Increases in intramural distension marginally correlated with the number of bowel segments involved (P=0.08). Three patients had free air and longer times to resolution of pneumatosis (P=0.03). Conclusion: Male children may be at increased risk of benign pneumatosis intestinalis. The incidence of benign pneumatosis at our institution is proportional to the number of hematopoietic stem cell transplants. The degree of intramural distension may correlate with the number of bowel segments involved. Patients with free air have a longer time to resolution of benign pneumatosis.",
keywords = "Cancer, Children, Hematopoietic stem cell transplant, Pneumatosis intestinalis",
author = "McCarville, {M. Beth} and Whittle, {Sarah B.} and Goodin, {Geoffrey S.} and Chin-Shang Li and Smeltzer, {Matthew P.} and Hale, {Gregory A.} and Kaufman, {Robert A.}",
year = "2008",
month = "10",
doi = "10.1007/s00247-008-0944-4",
language = "English (US)",
volume = "38",
pages = "1074--1083",
journal = "Pediatric Radiology",
issn = "0301-0449",
publisher = "Springer Verlag",
number = "10",

}

TY - JOUR

T1 - Clinical and CT features of benign pneumatosis intestinalis in pediatric hematopoietic stem cell transplant and oncology patients

AU - McCarville, M. Beth

AU - Whittle, Sarah B.

AU - Goodin, Geoffrey S.

AU - Li, Chin-Shang

AU - Smeltzer, Matthew P.

AU - Hale, Gregory A.

AU - Kaufman, Robert A.

PY - 2008/10

Y1 - 2008/10

N2 - Background: Pneumatosis intestinalis in children is associated with a wide variety of underlying conditions and often has a benign course. The CT features of this condition have not been systematically investigated. Objective: Defining benign pneumatosis intestinalis as pneumatosis intestinalis that resolved with medical management alone, we sought to: (1) determine whether the incidence of benign pneumatosis intestinalis had increased at our pediatric cancer hospital; (2) characterize CT features of benign pneumatosis intestinalis; and (3) determine the relationship between imaging features and clinical course of benign pneumatosis intestinalis in this cohort. Materials and methods: Radiology reports from November 1994 to December 2006 were searched for "pneumatosis intestinalis," "free intraperitoneal air," and "portal venous air or gas." Corresponding imaging was reviewed by two radiologists who confirmed pneumatosis intestinalis and recorded the presence of extraluminal free air, degree of intramural gaseous distension, number of involved bowel segments, and time to pneumatosis resolution. Results: The search revealed 12 boys and 4 girls with pneumatosis intestinalis; 11 were hematopoietic stem cell transplant recipients. The annual incidences of benign pneumatosis have not changed at our institution. Increases in intramural distension marginally correlated with the number of bowel segments involved (P=0.08). Three patients had free air and longer times to resolution of pneumatosis (P=0.03). Conclusion: Male children may be at increased risk of benign pneumatosis intestinalis. The incidence of benign pneumatosis at our institution is proportional to the number of hematopoietic stem cell transplants. The degree of intramural distension may correlate with the number of bowel segments involved. Patients with free air have a longer time to resolution of benign pneumatosis.

AB - Background: Pneumatosis intestinalis in children is associated with a wide variety of underlying conditions and often has a benign course. The CT features of this condition have not been systematically investigated. Objective: Defining benign pneumatosis intestinalis as pneumatosis intestinalis that resolved with medical management alone, we sought to: (1) determine whether the incidence of benign pneumatosis intestinalis had increased at our pediatric cancer hospital; (2) characterize CT features of benign pneumatosis intestinalis; and (3) determine the relationship between imaging features and clinical course of benign pneumatosis intestinalis in this cohort. Materials and methods: Radiology reports from November 1994 to December 2006 were searched for "pneumatosis intestinalis," "free intraperitoneal air," and "portal venous air or gas." Corresponding imaging was reviewed by two radiologists who confirmed pneumatosis intestinalis and recorded the presence of extraluminal free air, degree of intramural gaseous distension, number of involved bowel segments, and time to pneumatosis resolution. Results: The search revealed 12 boys and 4 girls with pneumatosis intestinalis; 11 were hematopoietic stem cell transplant recipients. The annual incidences of benign pneumatosis have not changed at our institution. Increases in intramural distension marginally correlated with the number of bowel segments involved (P=0.08). Three patients had free air and longer times to resolution of pneumatosis (P=0.03). Conclusion: Male children may be at increased risk of benign pneumatosis intestinalis. The incidence of benign pneumatosis at our institution is proportional to the number of hematopoietic stem cell transplants. The degree of intramural distension may correlate with the number of bowel segments involved. Patients with free air have a longer time to resolution of benign pneumatosis.

KW - Cancer

KW - Children

KW - Hematopoietic stem cell transplant

KW - Pneumatosis intestinalis

UR - http://www.scopus.com/inward/record.url?scp=51649109322&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=51649109322&partnerID=8YFLogxK

U2 - 10.1007/s00247-008-0944-4

DO - 10.1007/s00247-008-0944-4

M3 - Article

C2 - 18665358

AN - SCOPUS:51649109322

VL - 38

SP - 1074

EP - 1083

JO - Pediatric Radiology

JF - Pediatric Radiology

SN - 0301-0449

IS - 10

ER -