For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
13
views
14
references
 Top references
cited by
0
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      370
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Occult child abuse presenting as pneumatosis intestinalis and portomesenteric venous gas - a case report

      case-report

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Pneumatosis intestinalis and portomesenteric venous gas are usually caused by necrotizing enterocolitis; however they can occur secondary to abusive abdominal trauma with bone fractures and bruising. It is difficult to recognize initially if there is no bruising on the skin or bone fractures.

          Case presentation

          We report a 1-year-old child with no obvious history of trauma who presented with conscious disturbance. Abdominal computed tomography showed acute ischemic bowel complicated with pneumatosis intestinalis and portomesenteric venous gas. The first impression was septic shock with acute ischemic bowel. Two weeks after admission, brain magnetic resonance imaging showed subdural hemorrhage of different stages over bilateral fronto-parietal convexities and diffuse axonal injury, suggesting abusive head trauma. He was subsequently diagnosed with occult child abuse.

          Conclusion

          Pneumatosis intestinalis and portomesenteric venous gas are rare except in cases of prematurity. Occult abusive abdominal trauma should be considered as a differential diagnosis in patients with pneumatosis intestinalis and portomesenteric venous gas, even without any trauma on the skin or bone fractures.

          Related collections

          Most cited references14

          • Record: found
          • Abstract: found
          • Article: not found

          CT of acute bowel ischemia.

          Walter Wiesner, JAE-HOON JI, Pablo Ros … (2003)
          Bowel ischemia may be caused by many conditions and manifest with typical or atypical and specific or nonspecific clinical, laboratory, and radiologic findings. It may mimic various intestinal diseases and be confused with certain nonischemic conditions clinically and at computed tomography (CT). Bowel ischemia severity ranges from mild (generally transient superficial changes of intestinal mucosa) to more dangerous and potentially life-threatening transmural bowel wall necrosis. Causes of critically reduced blood flow to the bowel are diverse, ranging from occlusions of mesenteric arteries or veins to complicated bowel obstruction and overdistention. CT can demonstrate changes in ischemic bowel segments accurately, is often helpful in determining the primary cause of ischemia, and can demonstrate important coexistent findings or complications. Unfortunately, common CT findings in bowel ischemia are not specific, and specific findings are rather uncommon. Therefore, it often is a combination of nonspecific clinical, laboratory, and radiologic findings-especially detailed knowledge about the pathogenesis of acute bowel ischemia in different conditions-that helps most in correct interpretation of CT findings. To improve understanding of this complex heterogeneous entity, this article provides an overview of the anatomy and physiology of mesenteric perfusion and discussions of causes and pathogenesis of acute bowel ischemia, CT findings in various types of acute bowel ischemia, and potential pitfalls of CT.
          Article 0 comments Cited 68 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Diagnosis and management of blunt abdominal trauma.

            Joshua Davis, I Cohn, F C Nance (1976)
            The records of 437 patients with blunt abdominal trauma admitted to Charity Hospital, New Orleans, from 1967-1973 have been reviewed and computer-analyzed. There was an 80% increase in the incidence of blunt abdominal trauma when compared with the preceding 15-year experience. Forty-three per cent of all the patients presented with no specific complaint or sign of injury. Blunt abdominal injury was usually diagnosed preoperatively using conventional methods including history, physical examination, and routine laboratory tests and x-rays. Abdominal paracentesis via a Potter needle had an 86% accuracy. The incidence and management of specific organ injuries with associated morbidity and mortality have been discussed. Mortality and morbidity continue to be significant in blunt abdominal trauma. Isolated abdominal injuries rarely (5%) resulted in death, even though abdominal injuries accounted for 41% of all deaths. Associated injuries, especially head injury, greatly increased the risk. The insidious nature of blunt abdominal injury is borne out by the fact that more than one-third of the "asymptomatic" patients had an abdominal organ injured. A high index of suspicion and an adequate observation period therefore are mandatory for proper care of patients subjected to blunt trauma.
            Article 0 comments Cited 21 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: not found
              • Article: not found

              Pneumatosis coli: a proposed pathogenesis based on study of 25 cases and review of the literature

              I. Thompson, G. Gagliardi, I Talbot … (1996)
              Article 0 comments Cited 18 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Contributors
                En-Pei Lee: pilichrislnp@gmail.com
                Jainn-Jim Lin:
                ORCID: http://orcid.org/0000-0001-5592-6343
                +886-3-3281200 , lin0227@cgmh.org.tw
                Shao-Hsuan Hsia: tw1picu002@gmail.com
                Oi-Wa Chan: ai3333@adm.cgmh.org.tw
                Han-Ping Wu: arthur1226@gmail.com
                Journal
                Journal ID (nlm-ta): BMC Pediatr
                Journal ID (iso-abbrev): BMC Pediatr
                Title: BMC Pediatrics
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1471-2431
                Publication date (Electronic): 15 January 2019
                Publication date PMC-release: 15 January 2019
                Publication date Collection: 2019
                Volume: 19
                Electronic Location Identifier: 21
                Affiliations
                [1 ]Division of Pediatric Critical Care Medicine, and Pediatric Neurocritical Care Center, Chang Gung Children’s Hospital and Chang Gung Memorial Hospital, Taoyuan, Taiwan
                [2 ]GRID grid.145695.a, College of Medicine, , Chang Gung University, ; Taoyuan, Taiwan
                [3 ]Division of Pediatric General Medicine, Chang Gung Children’s Hospital and Chang Gung Memorial Hospital, Taoyuan, Taiwan
                [4 ]ISNI 0000 0001 0083 6092, GRID grid.254145.3, Department of Pediatric Emergency Medicine, Children’s Hospital, , China Medical University, ; Taichung, Taiwan
                [5 ]ISNI 0000 0001 0083 6092, GRID grid.254145.3, Department of Medicine, School of Medicine, , China Medical University, ; Taichung, Taiwan
                [6 ]ISNI 0000 0001 0083 6092, GRID grid.254145.3, Department of Medical Research, Children’s Hospital, , China Medical University, ; Taichung, Taiwan
                Author information
                http://orcid.org/0000-0001-5592-6343
                Article
                Publisher ID: 1382
                DOI: 10.1186/s12887-018-1382-6
                PMC ID: 6334378
                PubMed ID: 30646878
                SO-VID: ccbcf8a8-2075-4088-986c-bfb59bafd6ae
                Copyright © © The Author(s). 2019
                License:

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                Date received : 7 November 2016
                Date accepted : 21 December 2018
                Categories
                Subject: Case Report
                Custom metadata
                issue-copyright-statement © The Author(s) 2019

                ScienceOpen disciplines: Pediatrics
                Keywords: occult child abuse,pneumatosis intestinalis,portomesenteric venous gas,case report
                Data availability:
                ScienceOpen disciplines: Pediatrics
                Keywords: occult child abuse, pneumatosis intestinalis, portomesenteric venous gas, case report

                Comments

                Comment on this article