Pneumatosis Intestinalis With Abdominal Wall Emphysema in Hypothermia

In this report, we present a case in which intestinal and abdominal wall emphysema was observed, but the patient was unconscious due to hypothermia, making it difficult to determine the indication for surgery. Pneumatosis intestinalis (PI) is a pathological condition characterized by the presence of...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2023-02, Vol.15 (2), p.e34909
Main Authors: Kuwahara, Masaatsu, Otagaki, Hiroko, Imanaka, Hideaki
Format: Article
Language:English
Subjects:
Abdomen
Acidosis
Acids
Body temperature
Case reports
Consciousness
Creatinine
Emergency medical care
Emergency Medicine
Emphysema
Fainting
Gastroenterology
General Surgery
Glucose
Heart failure
Hypoglycemia
Hypothermia
Ischemia
Kinases
Laparotomy
Large intestine
Medical imaging
Metabolism
Peritonitis
Sepsis
Veins & arteries
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Summary:In this report, we present a case in which intestinal and abdominal wall emphysema was observed, but the patient was unconscious due to hypothermia, making it difficult to determine the indication for surgery. Pneumatosis intestinalis (PI) is a pathological condition characterized by the presence of gas within the walls of the small or large intestine and is considered a surgical emergency when accompanied by manifestations of peritonitis on abdominal examination, metabolic acidosis, and lactic acid levels above 2.0 mmol/L. In this specific case, the patient's blood draw results indicated the requirement for an emergency laparotomy; however, the patient's unconscious state became a challenge to make decision on informed consenting. The case illustrates the difficulties encountered in making treatment decisions in critically ill patients and the necessity for thorough assessments and close monitoring of vital signs in such patients.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.34909