title: Massive gas under diaphragm after lung transplantation: pneumatosis intestinalis simulating bowel perforation.
abstract: The management of pneumatosis intestinalis (PI) can vary from urgent surgical procedure to conservative treatment. Uncommonly, it has been reported in association with organ transplantation, and very few cases have been reported after lung transplantation. The transplant physicians should be well versed in differentiating the fatal form of PI from a benign one. Here, we describe a case of PI with pneumoperitoneum mimicking intestinal perforation after bilateral lung transplantation; this case posed a therapeutic dilemma. After discussion with the multidisciplinary teams, conservative management was chosen to which the patient responded successfully. Clinical signs and imaging features in these situations can mimic true bowel perforation. Hence, a correct diagnosis and proper assessment is imperative.
authors: Division of Heart and Lung Transplant, University of Alberta Hospital, Edmonton, Alberta, Canada. Electronic address: r_chandola@rediffmail.com.
authors: Rahul
authors: R
authors: Chandola
authors: Division of Heart and Lung Transplant, University of Alberta Hospital, Edmonton, Alberta, Canada.
authors: Abdelsalam
authors: A
authors: Elhenawy
authors: Division of Heart and Lung Transplant, University of Alberta Hospital, Edmonton, Alberta, Canada.
authors: Dale
authors: D
authors: Lien
authors: Division of Thoracic Surgery, Royal Alexandra Hospital, Edmonton, Alberta, Canada.
authors: Bryce
authors: B
authors: Laing
mesh_terms: D003937:Diagnosis, Differential; D003964:Diaphragm; D005740:Gases; D006801:Humans; D007416:Intestinal Perforation / Q000175:diagnosis*; D016040:Lung Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011006:Pneumatosis Cystoides Intestinalis / Q000175:diagnosis* / Q000209:etiology*
chemical_list: D005740:Gases