Pneumatosis intestinalis after liver transplantation

Area of Science:

• Gastroenterology
• Transplant Surgery
• Radiology

Background:

• Pneumatosis intestinalis (PI) is a rare complication following liver transplantation.
• Differentiating indolent from fulminant PI is crucial for patient management.

Purpose of the Study:

• To analyze clinical features and CT findings of PI in liver transplant recipients.
• To identify specific indicators for distinguishing indolent from fulminant PI.

Main Methods:

• Retrospective analysis of 2080 liver transplant recipients.
• 22 patients (1%) with PI were identified and divided into recovery and mortality groups.
• Clinical and CT findings were compared between groups.

Main Results:

• While indolent PI often presented incidentally after two weeks, statistical significance was not reached.
• Small bowel involvement and mesenteric vessel caliber changes were significantly associated with the mortality group.
• Fulminant PI cases showed higher rates of portomesenteric air-embolism, visceral infarction, hemorrhagic ascites, and small bowel ileus.

Conclusions:

• Indolent PI typically presents incidentally after two weeks post-transplant, but overlap with fulminant cases exists.
• CT findings such as small bowel involvement, mesenteric vessel caliber changes, portomesenteric air-embolism, visceral infarction, hemorrhagic ascites, and small bowel ileus are grave signs indicating a poor prognosis.