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Pneumatosis intestinalis and portal vein gas after blunt abdominal trauma
B Gurland1, S E Dolgin, E Shlasko
1Mt Sinai Medical Center, New York, NY 10029, USA.
Journal of Pediatric Surgery
|August 29, 1998
Insights
Pneumatosis intestinalis (PI) and portal vein gas (PVG) in a child resulted from blunt abdominal trauma due to abuse. This indicates mucosal injury but not necessarily bowel necrosis.
Area of Science:
- Pediatric surgery
- Abdominal trauma
- Medical imaging
Background:
- Blunt abdominal trauma can cause severe intra-abdominal injuries.
- Child abuse is a significant cause of pediatric trauma.
- Pneumatosis intestinalis and portal vein gas are concerning radiological findings.
Observation:
- A 2-year-old boy presented with symptoms following blunt abdominal trauma.
- Radiological imaging revealed pneumatosis intestinalis and portal vein gas.
- The trauma was attributed to child abuse.
Findings:
- The presence of pneumatosis intestinalis and portal vein gas was linked to mechanical forces from the trauma.
- These findings suggest significant mucosal injury to the bowel.
- Intestinal necrosis was not definitively established in this case.
Implications:
- Child abuse should be considered in cases of unexplained abdominal trauma with these radiological signs.
- Pneumatosis intestinalis and portal vein gas in this context suggest mechanical injury.
- Further investigation is needed to differentiate mucosal injury from necrosis.
Abstract:
The authors report on a 2-year-old boy in whom pneumatosis intestinalis (PI) and portal vein gas (PVG) resulted from blunt abdominal trauma after child abuse. The presumed pathophysiology of PI and PVG is mechanical in this setting. Its presence establishes mucosal injury but does not necessarily imply intestinal necrosis.