{
  "abstract": "Patients with neurodisability can lack the capacity to communicate their symptoms. Understanding the natural history and implications of Pneumatosis Intestinalis (PI) in this group of patients could help refine diagnostic and therapeutic strategies, potentially sparing unnecessary surgical interventions. A retrospective keyword search of a radiology database identified patients diagnosed with PI via imaging over a 10 year period (2014–2024). Exclusion criteria were applied, selecting paediatric patients 6 months to 16 years of age with PI and neurodisability. Patient notes were analysed to identify: 1) subtle or atypical signs that may be present despite lack of clear symptoms 2) patients management 3) patient outcomes in form of clinical resolution and recurrence of PI. Five patients were identified ( table 1).Abstract OC73 Table 1 Patient 1 Patient 2 Patient 3 Patient 4 Patient 5 Demographics:- Age at finding -Sex (M – male, F – female) 6 yearsM 7 monthsF 1 year 5 monthsF 3 yearsM 11 yearsF Feeding Method Gastrostomy Nasojejunal Gastrostomy GastrostomyJejunostomy Jejunostomy Neurological diagnosis Pompe disease Undiagnosed neurological disorder with dystoniaSevere development delay MicrocephalySevere development delay Epileptic encephalopathyCentral hypotonia, muscle weakness, severe development delay Mitochondrial depletion (SERAC1 mutation) syndromeProfound Learning DisabilityEpilepsy Clinical presentation Respiratory failure Drowsy, less responsive hypothermic, hypotonic,Abdominal distention BronchiolitisAbdomen distended,Per rectum bleeding Increased loose stool, bloating, evidence of discomfort AsymptomaticBlood in stool 2 weeks prior Imaging Bubbly lucencies below diaphragm Distended abdomen with several loops of dilated gas-filled bowel.Bubbly lucencies within left flank Intramural gas within the bowel in the upper left quadrant Extensive bowel wall thickening with intramural gas Extremely severe and widespread pneumatosis PneumoperitoneumPresent? No No No No Yes (on 2nd admission) Management(NBM - nil by mouth, Abx - antibiotics, PN - parenteral nutrition) Treated for respiratory failure with 1 week TazocinConservative management for Pneumatosis NBM + Metronidazole IV abx + NBM + PN Abx + NBM Abx + NBM + PN PI duration 32 days 17 days 50 days 5 days 487 days (ongoing) Recurrent Episodes(PI on separate admission) 0 0 0 0 2 All 5 patients were managed conservatively, with all but one having resolution of PI noted on imaging. In the absence of any specific surgical intervention, only one patient experienced recurrent PI. Despite this, the patient remained asymptomatic from a gastrointestinal perspective on each subsequent episode. These cases demonstrate that a conservative approach to management can be effective and should not be ruled out in favour of surgical management.",
  "authors": [
    {
      "affiliations": [
        "Leeds Teaching Hospitals NHS Trust"
      ],
      "name": "Roshan Woods"
    },
    {
      "affiliations": [
        "Leeds Teaching Hospitals NHS Trust"
      ],
      "name": "Lilianne Gomez Lopez"
    },
    {
      "affiliations": [
        "Leeds Teaching Hospitals NHS Trust"
      ],
      "name": "Elena Cernat"
    }
  ],
  "title": "OC73 Pneumatosis intestinalis in paediatric patients with neurodisability: a case series",
  "uid": "094d9b8f-3a61-53b4-be41-5545c58d3a5f"
}