Pneumatosis cystoides intestinalis, a rare case in a pediatric patient following allogeneic hematopoietic stem cell transplantation: CT findings and literature review

Relation between partial arterial carbon dioxide pressure and pH value and optic nerve sheath diameter: a prospective self-controlled non-randomized trial study

OBJECTIVE

This study aims to determine if there is a correlation between differences in optic nerve sheath diameter (ONSD) and changes in PaCO2 and pH values that were measured in the arterial blood gas (ABG) before and after treatment in COPD patients with acute hypercarbic respiratory failure (AHRF).

MATERIALS AND METHODS

This study serves as a prospective self-controlled non-randomized trial study conducted in the emergency clinic of a tertiary hospital. Forty-four patients with COPD, who were found to have acidosis and hypercarbia in ABG and had an indication for non-invasive mechanic ventilation (NIMV), were analyzed prospectively. Demographic information, vital findings, initial ABG values, the ONSD measurement (before the NIMV treatment), consciousness state, and the ABG results obtained in the second hour of the monitoring and the ONSD measurement (after the NIMV treatment) were recorded.

RESULTS

In this study, 13 (29.5%) of the patients were female and 31 (70.5%) were male. The age distribution was evaluated as 68.3 ± 9.2 years; the minimum age was 54 and the maximum was 91. A high level of positively significant correlation was found between the mean ONSD and PaCO2 (p < 0.0001). There is a high fit (0.72) between the mean ONSD and PaCO2. A moderate level of negatively significant correlation was found between the mean ONSD and the pH (p < 0.0001). However, there is an insignificant low fit (0.32) between the mean ONSD and the pH.

CONCLUSION

The ONSD changed significantly and in a highly correlated manner to acute changes in PaCO2 levels.

Pneumatosis cystoides intestinalis accompanied by schistosomiasis: a case report

Pneumatosis cystoides intestinalis (PCI) is a rare disease that most frequently occurs in the large and small intestine and has no obvious clinical symptoms. The main pathological feature is the presence of air-filled cysts in the intestinal submucosa, intermuscular wall, and subserous membrane. Conservative treatment is the first choice when no serious complications are present, whereas timely surgical treatment is needed for serious and life-threatening complications. This report presents the clinical and pathological analysis of PCI in a man in his early 90s. The patient was hospitalized because of acute abdomen and diagnosed with perforation of the sigmoid colon due to PCI with schistosomiasis after emergency surgery. Emergency partial sigmoid colon resection and permanent colostomy were performed under general anesthesia. Preoperative diagnosis of PCI is difficult because of the nonspecific clinical manifestations and endoscopic findings, and missed diagnosis and misdiagnosis easily occur. Pure PCI has no specific symptoms and does not require special treatment, and there is a lack of special treatment methods in clinical practice. However, when PCI is combined with other intestinal diseases such as schistosomiasis enteropathy, intestinal perforation is likely to occur, leading to severe acute abdomen with the need for prompt surgical treatment.