PNEUMATOSIS INTESTINALIS IN THE NEONATE

¹ Advanced Fellow in Academic Radiology of the James Picker Foundation as recommended by the NRC/NAS.

Pneumatosis intestinalis (intramural bowel air) can be seen in several disease processes during the neonatal period, notably mechanical obstruction, vascular compromise, and necrotizing enterocolitis.

Pneumatosis intestinalis seen with mechanical obstruction is often uneventful and self-limiting when the obstruction is relieved.

Necrotizing enterocolitis will usually have a characteristic presentation of early onset in premature infants with distention, bile-stained emesis, and blood in the stool.

Vascular thromboses with subsequent bowel ischemia can mimic necrotizing enterocolitis, but will occur later in the newborn period, may be localized to small bowel, and may be associated with indwelling umbilical artery catheters. Recovery is often complicated by indeterminate periods of malabsorption.

The diagnosis of the underlying disease leading to pneumatosis intestinalis is necessary for proper management.

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