Letter to the Editor
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 28, 2022; 28(28): 3739-3742
Published online Jul 28, 2022. doi: 10.3748/wjg.v28.i28.3739
Prednisolone induced pneumatosis coli and pneumoperitoneum
Serene S N Goh, Vishal Shelat
Serene S N Goh, Vishal Shelat, Department of General Surgery, Tan Tock Seng Hospital, Singapore 308433, Singapore
Author contributions: Goh SSN wrote the letter; Shelat V revised the letter.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Serene S N Goh, MMed, Doctor, Department of General Surgery, Tan Tock Seng Hospital, 11 Jln Tan Tock Seng, Singapore 308433, Singapore. serene.goh@mohh.com.sg
Received: October 30, 2021
Peer-review started: October 30, 2021
First decision: April 16, 2022
Revised: May 4, 2022
Accepted: July 11, 2022
Article in press: July 11, 2022
Published online: July 28, 2022
Processing time: 269 Days and 12.1 Hours
Abstract

Pneumatosis intestinalis (PI) is defined as the presence of gas within the submucosal or subserosal layer of the gastrointestinal tract. It is a radiologic sign suspicious for bowel ischemia, hence non-viable bowel must be ruled out in patients with PI. However, up to 15% of cases with PI are not associated with bowel ischemia or acute abdomen. We described an asymptomatic patient with prednisolone-induced PI and modified the Naranjo score to aid in a surgeon’s decision-making for emergency laparotomy vs non-operative management with serial assessment in patients who are immunocompromised due to long-term steroid use.

Keywords: Benign pneumatosis; Pneumatosis coli; Pneumatosis intestinalis; Prednisolone

Core Tip: We described an asymptomatic patient with prednisolone-induced pneumatosis intestinalis and modified the Naranjo score to aid in a surgeon’s decision-making for emergency laparotomy vs non-operative management with serial assessment in patients who are immunocompromised due to long-term steroid use.