Citation

Deutsch SA, Christian CW. Pediatr. Emerg. Care 2016; ePub(ePub): ePub.

Affiliation

From the *Department of General Pediatrics, Children's Hospital of Philadelphia; and †Department of Pediatrics, The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, PA.

Copyright

(Copyright © 2016, Lippincott Williams and Wilkins)

DOI

10.1097/PEC.0000000000000976

PMID

27902668

Abstract

Pneumatosis intestinalis (PI) and the presence of portal venous gas (PVG) are commonly considered pathognomonic for necrotizing enterocolitis in the neonatal period; however, these 2 radiographic findings have been documented in all age groups in a variety of clinical settings and medical conditions including respiratory, cardiac, rheumatologic, gastrointestinal disorders, and traumatic injury. In children, intramural dissection of intestinal gas in the absence of clinical symptoms suggestive of necrotizing enterocolitis should raise concern for a traumatic etiology, including injuries sustained from child physical abuse. Several pediatric cases of traumatic PI and PVG have been reported; however, these cases described additional, associated abdominal injury or featured toddlers - a single case report of accidental abdominal trauma resulted in PVG in a preterm infant. We report the case of a neonatal victim of child physical abuse presenting with PI and PVG in the absence of other evidence of abdominal trauma.

Language: en