Ferrada et al reported factors predictive of transmural ischemia in a patient with pneumatosis intestinalis. This can help to identify a patient who may benefit from urgent surgery. The authors are from multiple institutions in the United States and Brazil.
Patient selection: adult with pneumatosis intestinalis
Predictors for transmural ischemia (pathologic pneumatosis):
(1) blood lactate >= 2.0 mmol/L (OR 5.0)
(2) elevated INR (probably > 1.2; OR 4.1)
(3) decreased hemoglobin in g/dL (anemiaOR 0.7)
(4) peritonitis (OR 35.8)
The chance of pathologic pneumatosis was 3% if all of the predictors are present (with hemoglobin 14 g/dL).
The chance of pathologic pneumatosis was 89% if all of the predictors are present (with hemoglobin 10 g/dL).
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