IMAGES IN EMERGENCY MEDICINE
Tramlines: pneumatosis intestinalis secondary to enterocolitis
1 John Radcliffe Hospital, Oxford, UK
2 University Department of Paediatrics, John Radcliffe Hospital, Oxford, UK
3 Department of Paediatric Surgery, John Radcliffe Hospital, Oxford, UK
Correspondence to:
Correspondence to:
J Corcoran
John Radcliffe Hospital, Oxford OX3 9DU, UK; jpcorcoran@doctors.org.uk
Accepted 16 July 2006
| The first 150 words of the full text of this article appear below. |
An 11-month-old boy presented acutely with a 3-day history of fever, vomiting and diarrhoea. A background of recent gastroenteritis among family members was noted. On admission, the patient was lethargic, dehydrated and had tachypnoea; general examination was otherwise unremarkable.
A provisional diagnosis of viral gastroenteritis was made. However, the tachypnoea prompted a venous blood gas examination, showing a metabolic acidosis that persisted despite fluid resuscitation and apparent clinical improvement. Suspecting intussusception, abdominal ultrasound and radiography were requested. The ultrasound was normal, but the plain radiograph (fig 1
) showed the classical "tramlines" of intramural gas.
[in a new window] Figure 1 The abdominal radiograph shows the classical "tramline" pattern seen in pneumatosis intestinalis, created by gas trapped between layers of the bowel wall and most obvious here in the descending colon.
| |||||||||
Pneumatosis intestinalis is generally viewed with foreboding by clinicians owing to its association with necrotising enterocolitis in neonates. However, outside the neonatal period, pneumatosis intestinalis
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
- Full Text
- Full Text (PDF)
- Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
Services
- Email this link to a friend
- Similar articles in this journal
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
PubMed
Topic Collections
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
