The purpose of the study is to validate the predictors for bowel necrosis we previously identified in the retrospective review, on this prospective study.
The pathogenesis of pneumatosis intestinalis (PI) or air in the intestinal wall is poorly understood. Since discovering PI in CT scan can fluctuate from necrotic bowel to a benign finding, it is pivotal to help the surgeon decide when to intervene to prevent poor patient outcomes.
The present group has devoted the last few years to understand the significance of this finding in changing surgical management, in conjunction with other clinical predictors of pathology.1
We previously published a retrospective review of 500 patients with PI. In this review, we identified a lactate greater than 2.0 mmol/L as the strongest independent predictors of pathologic PI. Other factors such as peritonitis, hypotension or vasopressor need, acute renal failure, active mechanical ventilation, and absent bowel sounds also demonstrated significance.
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