Lactulose-induced pneumatosis intestinalis and pneumoperitoneum.
A case of PI in a 57-year-old patient with colonic inertia treated with lactulose for PSE secondary to cirrhosis is described. The colonic inertia led to longer transit time. Retained lactulose and a build-up of carbon dioxide and hydrogen gas occurred in the setting of altered bacterial flora deficient in hydrogen metabolism. The increased gas pressure caused extravasation of air into the intestine, causing PI with pneumoperitoneum. They both resolved with discontinuation of lactulose.
Goodman
R A
RA
Department of Medicine, The Hershey Medical Center, Pennsylvania State University, College of Medicine, 17033, USA.
Riley
T R
TR
D006801:Humans; D007792:Lactulose / Q000009:adverse effects* / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011006:Pneumatosis Cystoides Intestinalis / Q000139:chemically induced*; D011027:Pneumoperitoneum / Q000139:chemically induced*
D007792:Lactulose