Pneumatosis intestinalis and pneumoperitoneum after bilateral lung transplantation in adults.
Pneumatosis intestinalis and pneumoperitoneum after bilateral lung transplantation in adults.
复制标题
成人双侧肺移植后肠积气和气腹。
DOI：
10.2214/ajr.10.4468
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发表时间：
2011
期刊：
影响因子：
--
通讯作者：
C. Marroquin
中科院分区：
文献类型：
--
作者：
W. M. Thompson;L. Ho;C. Marroquin
目的
本文的目的是确定双侧肺移植受者发生肺积气（PI）或气腹的临床特征、影像学表现和可能原因。
材料和方法
从2004年12月至2009年7月，321例双侧肺移植受者中有7例（2%）（2名女性和5名男性;年龄范围，25-66岁）发生PI或气腹，或两者兼而有之。审查病历，以确定PI或气腹出现时的临床表现、实验室检查结果和药物治疗。记录住院过程和PI或气腹消退的时间。评价了可能解释PI和气腹原因的常见因素。两名经验丰富的腹部放射科医生审查了所有的成像研究，并记录了每个病人的具体结果。
结果
所有患者症状轻微或无症状，实验室检查结果正常，无全身、肠道或经证实的呼吸道感染。除一名患者外，所有患者均接受三联免疫抑制剂（即，泼尼松、硫唑嘌呤和他克莫司）。影像学检查结果是相似的，在五个病人的PI占主导地位的线性和囊性外观，只涉及结肠。6例PI患者中有3例同时存在PI和气腹。PI消退的平均时间为24天。在7例患者中，无法确定PI和气腹的确切原因。
结论
双侧肺移植受者术后可能发生良性PI或气腹。双侧肺移植受者的良性PI具有相似和特异的线性和囊性外观，并且不是由于缺血性肠。无法确定PI和气腹的具体原因。
OBJECTIVE
The purpose of this article is to determine the clinical features, imaging findings, and possible causes of pneumatosis intestinalis (PI) or pneumoperitoneum that developed in bilateral lung transplant recipients.
MATERIALS AND METHODS
From December 2004 to July 2009, seven (2%) of 321 bilateral lung transplant recipients (two women and five men; age range, 25-66 years) who developed PI or pneumoperitoneum, or both, were identified. Medical records were reviewed to determine the clinical presentation, laboratory findings, and medications at the time of presentation of PI or pneumoperitoneum. Hospital course and time to resolution of PI or pneumoperitoneum were recorded. Common factors that might explain the cause of the PI and pneumoperitoneum were evaluated. Two experienced abdominal radiologists reviewed all imaging studies and recorded the specific findings for each patient.
RESULTS
All patients had minimal or no symptoms, normal laboratory study results, and no systemic, intestinal, or proven respiratory infections. All patients but one were receiving triple immunosuppressive agents (i.e., prednisone, azathioprine, and tacrolimus). The imaging findings were similar in five of the patients with the PI dominated by a linear and cystic appearance and involving only the colon. Three of the six patients with PI had both PI and pneumoperitoneum. The mean time to resolution of PI was 24 days. No definite cause for the PI and pneumoperitoneum could be determined in the seven patients.
CONCLUSION
Bilateral lung transplant recipients may develop benign PI or pneumoperitoneum after surgery. Benign PI in bilateral lung transplant recipients has a similar and specific linear and cystic appearance and is not due to ischemic bowel. No specific cause for the PI and pneumoperitoneum could be determined.