Varelas LJ, Klinge MJ, Malik SM, Borhani AA, Neal M. Idiopathic Pneumatosis Intestinalis Secondary to Lactulose Use in Patients with Cirrhosis. J Gastroenterol Hepatol. 2019 Nov 6. doi: 10.1111/jgh.14920. PubMed PMID: 31692099.
BACKGROUND & AIMS: Few case reports exist that link lactulose use with pneumatosis intestinalis in cirrhotics. This study investigates the relationship between lactulose use and idiopathic pneumatosis intestinalis in a cohort of cirrhotic patients.
METHODS: This case series considers several notable cases of patients with idiopathic pneumatosis intestinalis and concurrent lactulose use. Idiopathic pneumatosis intestinalis was defined as pneumatosis intestinalis with no identifiable etiology. A cohort of 119 patients with cirrhosis and pneumatosis intestinalis were identified in a tertiary care setting, via chart review by a multidisciplinary team. Eleven of these patients were found to have idiopathic pneumatosis intestinalis. Nine of these patients were being treated with lactulose.
RESULTS: Six out of 9 patients with idiopathic pneumatosis intestinalis that were being treated with lactulose saw resolution of pneumatosis intestinalis following discontinuation of treatment.
CONCLUSION: The etiology of idiopathic pneumatosis intestinalis is likely multifactorial, but lactulose might play a preventable role in its formation.
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