Clinical Predictors and Outcomes for Recurrent Pneumatosis Intestinalis in Children
A Case Control Study
Source of Funding: NIH T32 DK007727-ADT.
The authors report no conflicts of interest.
Author Contributions: A. Ta: Primary author who generated the concepts, acquisition of clinical documentation, performed statistical analysis, drafting manuscript, and final compiling of manuscript for submission.
M. Farrell: Provided guidance for concept generation, reviewed abstract, presented work at national conference, reviewed, and provided edits to manuscript.
J. Dillman: Provided guidance for concept generation, reviewed all images for diagnosis of pneumatosis, reviewed abstract, reviewed, and provided guidance for manuscript generation.
A. Trout: Provided guidance for concept generation, reviewed all images for diagnosis of pneumatosis, reviewed abstract, reviewed, and provided guidance for manuscript generation.
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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.
