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Multimodality Diagnosis of Mesenteric Ischemia
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Portomesenteric vein gas: diagnostic and prognostic value
Francesco Lassandro1, Mariano Scaglione, Giovanni Rossi
1Department of Radiology, A. O. R. N. Cardarelli Hospital, Napoli, Italy. f.lassandro@tiscalinet.it
Emergency Radiology
|August 4, 2004
Summary
Portomesenteric pneumatosis, gas in the portomesenteric veins, reliably indicates intestinal infarction and poor prognosis. However, this finding suggests a better outcome in trauma patients.
Area of Science:
- Radiology
- Gastroenterology
- Surgical Outcomes
Background:
- Portomesenteric pneumatosis (PMP) is traditionally linked to intestinal infarction and adverse outcomes.
- Recent research has challenged the definitive clinical significance of PMP.
- The diagnostic and prognostic value of PMP requires further clarification.
Purpose of the Study:
- To retrospectively evaluate the diagnostic and prognostic significance of portomesenteric pneumatosis.
- To correlate the computed tomography (CT) finding of portomesenteric vein gas with clinical data and patient outcomes.
Main Methods:
- Retrospective analysis of 47 patients with CT-identified portomesenteric pneumatosis.
- Correlation of imaging findings with surgical data and clinical outcomes.
- Assessment of survival rates based on the underlying cause of PMP.
Main Results:
- Portomesenteric pneumatosis was present in 83% of patients with surgical evidence of intestinal infarction.
- Overall survival was 31.9% (15/47), with only 8/39 patients with intestinal infarction surviving.
- In trauma patients, PMP was associated with a comparatively better prognosis.
Conclusions:
- Portomesenteric pneumatosis is a significant indicator of intestinal infarction and poor prognosis.
- The prognostic implication of PMP differs in trauma patients, where it suggests a better outcome.
- CT detection of portomesenteric vein gas remains a critical diagnostic and prognostic tool in abdominal emergencies.
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