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Pneumatosis intestinalis in a preterm infant: should we treat all intestinal pneumatosis as necrotising enterocolitis?
  1. Siu Jun Chew1,
  2. Rajadurai Samuel Victor1,2,3,4,
  3. Krishna Revanna Gopagondanahalli1,4,
  4. Suresh Chandran1,2,3,4
  1. 1Department of Neonatology, KK Women’s and Children’s Hospital, Singapore
  2. 2Duke NUS Medical School, Singapore
  3. 3LKC School of Medicine, Singapore
  4. 4YLL NUS School of Medicine, Singapore
  1. Correspondence to Associate Professor Suresh Chandran, schandran1312{at}


Gastric pneumatosisis a very rare site of pneumatosis intestinalis (PI), and we report this finding in a preterm female infant with cyanotic congenital heart disease. The infant was stable initially on nasal intermittent mandatory ventilation; however, torrential pulmonary flow through a large patent ductus arteriosus prompted closure using oral ibuprofen. After an episode of haematochezia, she developed PI, affecting mainly the gastric wall and small intestine with portal venous gas. Her bowel movements were regular, with no abdominal distension or significant gastric aspirates. She was haemodynamically stable with negative infective markers. Management consisted of endotracheal intubation and ventilation, gastric decompression and broad-spectrum antibiotics. Both the gastric and intestinal pneumatosis resolved within 24 hours and she made an uneventful recovery. If PI is not due to necrotising enterocolitis, enteral nutrition can be initiated early and prolonged course of broad-spectrum antibiotics could have been avoided.

  • gastrointestinal system
  • cardiovascular system
  • contraindications and precautions

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  • RSV and SC contributed equally.

  • SJC and KRG contributed equally.

  • Contributors SJC: manuscript preparation and review of literature. KRG: manuscript preparation and literature review. RSV and SC: Manuscript preparation, literature review and involved with antenatal planning, delivery and management of the case.

  • Funding We authors declare that there was no grant for this research from any funding agency.

  • Competing interests None declared.

  • Patient consent Guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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