Lee J Varelas1, Matthew J Klinge2, Shahid M Malik2, Amir A Borhani3, Matthew Neal4. 1. Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh School of Medicine. 2. Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. 3. Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. 4. Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Abstract
BACKGROUND AND AIM: Few case reports exist that link lactulose use with pneumatosis intestinalis in cirrhotics. This study investigates the relationship between lactulose use and idiopathic pneumatosis intestinalis in a cohort of cirrhotic patients. METHODS: This case series considers several notable cases of patients with idiopathic pneumatosis intestinalis and concurrent lactulose use. Idiopathic pneumatosis intestinalis was defined as pneumatosis intestinalis with no identifiable etiology. A cohort of 119 patients with cirrhosis and pneumatosis intestinalis were identified in a tertiary care setting, via chart review by a multidisciplinary team. Eleven of these patients were found to have idiopathic pneumatosis intestinalis. Nine of these patients were being treated with lactulose. RESULTS: Six out of 9 patients with idiopathic pneumatosis intestinalis that were being treated with lactulose saw resolution of pneumatosis intestinalis following discontinuation of treatment. CONCLUSIONS: The etiology of idiopathic pneumatosis intestinalis is likely multifactorial, but lactulose might play a preventable role in its formation.
BACKGROUND AND AIM: Few case reports exist that link lactulose use with pneumatosis intestinalis in cirrhotics. This study investigates the relationship between lactulose use and idiopathic pneumatosis intestinalis in a cohort of cirrhoticpatients. METHODS: This case series considers several notable cases of patients with idiopathic pneumatosis intestinalis and concurrent lactulose use. Idiopathic pneumatosis intestinalis was defined as pneumatosis intestinalis with no identifiable etiology. A cohort of 119 patients with cirrhosis and pneumatosis intestinalis were identified in a tertiary care setting, via chart review by a multidisciplinary team. Eleven of these patients were found to have idiopathic pneumatosis intestinalis. Nine of these patients were being treated with lactulose. RESULTS: Six out of 9 patients with idiopathic pneumatosis intestinalis that were being treated with lactulose saw resolution of pneumatosis intestinalis following discontinuation of treatment. CONCLUSIONS: The etiology of idiopathic pneumatosis intestinalis is likely multifactorial, but lactulose might play a preventable role in its formation.
Authors: Santiago J Miyara; Lance B Becker; Sara Guevara; Claudia Kirsch; Christine N Metz; Muhammad Shoaib; Elliot Grodstein; Vinay V Nair; Nicholas Jandovitz; Alexia McCann-Molmenti; Kei Hayashida; Ryosuke Takegawa; Koichiro Shinozaki; Tsukasa Yagi; Tomoaki Aoki; Mitsuaki Nishikimi; Rishabh C Choudhary; Young Min Cho; Stavros Zanos; Stefanos Zafeiropoulos; Hannah B Hoffman; Stacey Watt; Claudio M Lumermann; Judith Aronsohn; Linda Shore-Lesserson; Ernesto P Molmenti Journal: Front Med (Lausanne) Date: 2021-06-04