Pneumatosis intestinalis in adults with AIDS: clinical significance and imaging findings

• Published in: American journal of roentgenology (1976) Vol. 165; no. 6; pp. 1387 - 1390
• Main Authors: Wood, BJ, Kumar, PN, Cooper, C, Silverman, PM, Zeman, RK
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Leesburg, VA Am Roentgen Ray Soc 01.12.1995; American Roentgen Ray Society
• Subjects: Acquired Immunodeficiency Syndrome - complications; Acquired Immunodeficiency Syndrome - diagnostic imaging; Adult; AIDS/HIV; Biological and medical sciences; Cecum - diagnostic imaging; Colon - diagnostic imaging; Diarrhea - diagnostic imaging; Diarrhea - etiology; HIV-1; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Male; Medical sciences; Pneumatosis Cystoides Intestinalis - diagnostic imaging; Pneumatosis Cystoides Intestinalis - etiology; Retrospective Studies; Tomography, X-Ray Computed; Human; Immunopathology; Radiodiagnosis; Gut; Exploration; AIDS; Immune deficiency; Infection; Pneumatosis; Viral disease; Digestive diseases; Complication; Intestinal disease
• ISSN: 0361-803X; 1546-3141
• DOI: 10.2214/ajr.165.6.7484571

The significance of pneumatosis intestinalis in adults with AIDS is unknown. Adults with AIDS are predisposed to pneumatosis intestinalis. The purpose of this study is to determine the clinical significance and to characterize the imaging appearance of this finding in patients with AIDS. In just over 3 years at our institution, pneumatosis intestinalis in adults with AIDS was detected in six cases. Medical records of those cases were retrospectively analyzed for clinical history, laboratory data, and surgical and pathologic findings. CT scans and abdominal radiographs were analyzed for location and severity of pneumatosis, presence of portal venous gas, pneumoperitoneum, and cystic versus linear gas. Five of the six patients with AIDS-associated pneumatosis intestinalis were managed conservatively or medically without surgical procedures and were discharged from the hospital with resolved or decreasing gastrointestinal complaints. The other patient underwent an exploratory laparotomy because of free intraperitoneal and retroperitoneal air; however, no bowel perforation was found at surgery. Pneumatosis intestinalis is a late-stage phenomenon in adult patients with AIDS that characteristically involves the cecum or right colon. Pneumatosis in patients with AIDS may be an indolent abnormality and does not necessarily constitute a surgical emergency or a sign of impending bowel necrosis.