Benign pneumatosis in children.
BACKGROUND
In pediatrics, pneumatosis intestinalis (PI) is usually due to necrotizing enterocolitis in premature newborns. Beyond infancy, PI is uncommon. "Benign pneumatosis" is PI in patients with few or no symptoms that resolves with conservative management.


OBJECTIVE
Our goal was to better characterize benign PI in children. Our investigation focused on identifying underlying risk factors, symptoms at time of diagnosis, management and outcome.


METHODS
Available medical records and radiographs of children with pneumatosis intestinalis from 1990 to 1998 were reviewed for underlying conditions, symptoms at time of radiographs, management and outcome.


RESULTS
Thirty-seven children (mean age 4 years) were included. Thirty-two children had identifiable risk factors. Twenty-five children were immunocompromised by their underlying conditions or therapeutic regimen. Thirty-five children were managed conservatively with resolution of PI. Two patients, however, required surgery and one patient died.


CONCLUSIONS
Benign pneumatosis does occur in children. The majority have underlying risk factors, most commonly related to immunosuppression. Clinical deterioration is the most useful indicator for surgical intervention. In most patients PI resolves with conservative management.
Fenton
L Z
LZ
Department of Radiology, Children's Hospital, Boston, MA 02115, USA. fenton.laura@tchden.org
Buonomo
C
C
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011006:Pneumatosis Cystoides Intestinalis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D011859:Radiography; D012307:Risk Factors; D016896:Treatment Outcome