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

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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.

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Acknowledgement

This study was supported in part by The Pediatric Oncology Education Program grant 5R25 CA23944 from the National Cancer Institute and The American, Lebanese and Syrian Associated Charities.

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Authors and Affiliations

  1. Department of Radiological Sciences, St. Jude Children’s Research Hospital, 332 North Lauderdale Street, Memphis, TN, 38105, USA

    M. Beth McCarville, Sarah B. Whittle, Geoffrey S. Goodin & Robert A. Kaufman

  2. Department of Radiology, The University of Tennessee College of Medicine, Memphis, TN, USA

    M. Beth McCarville, Geoffrey S. Goodin & Robert A. Kaufman

  3. Department of Biostatistics, St. Jude Children’s Research Hospital, Memphis, TN, USA

    Chin-Shang Li & Matthew P. Smeltzer

  4. Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN, USA

    Gregory A. Hale

  5. Department of Pediatrics, The University of Tennessee College of Medicine, Memphis, TN, USA

    Gregory A. Hale & Robert A. Kaufman

Authors
  1. M. Beth McCarville
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  2. Sarah B. Whittle
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  3. Geoffrey S. Goodin
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  4. Chin-Shang Li
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  5. Matthew P. Smeltzer
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  6. Gregory A. Hale
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  7. Robert A. Kaufman
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Corresponding author

Correspondence to M. Beth McCarville.

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McCarville, M.B., Whittle, S.B., Goodin, G.S. et al. Clinical and CT features of benign pneumatosis intestinalis in pediatric hematopoietic stem cell transplant and oncology patients. Pediatr Radiol 38, 1074–1083 (2008). https://doi.org/10.1007/s00247-008-0944-4

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  • DOI: https://doi.org/10.1007/s00247-008-0944-4

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