Idiopathic pneumatosis intestinalis secondary to lactulose use in patients with cirrhosis

Lee J. Varelas, Matthew J. Klinge, Shahid M. Malik*, Amir A. Borhani, Matthew Neal

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Background and Aim: 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. Conclusions: The etiology of idiopathic pneumatosis intestinalis is likely multifactorial, but lactulose might play a preventable role in its formation.

Original languageEnglish (US)
Pages (from-to)1065-1068
Number of pages4
JournalJournal of Gastroenterology and Hepatology (Australia)
Issue number6
StatePublished - Jun 1 2020


  • hepatic encephalopathy
  • lactulose
  • liver cirrhosis
  • liver imaging
  • pneumatosis intestinalis

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology


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