{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T10:17:54Z","timestamp":1785838674426,"version":"3.56.0"},"reference-count":47,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T00:00:00Z","timestamp":1738627200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T00:00:00Z","timestamp":1738627200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pneumatosis intestinalis, characterised by the presence of intramural bowel gas, is a radiological finding with varied clinical implications, ranging from incidental detection to severe underlying pathology, including bowel ischaemia or perforation. Its association with systemic sclerosis, a connective tissue disorder, remains rare and poorly understood, presenting unique diagnostic and therapeutic challenges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comprehensive literature review was conducted, analysing 34 documented cases of pneumatosis intestinalis associated with systemic sclerosis, examining demographic profiles, clinical features, diagnostic findings, and outcomes of various management strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Pneumatosis intestinalis in systemic sclerosis predominantly occurs in older female patients and is associated with gastrointestinal dysmotility and microvascular damage. Symptoms range from asymptomatic presentations to severe abdominal pain with obstructive symptoms, with the latter increasing the likelihood of surgical intervention. Non\u2010operative management, encompassing antibiotic therapy, oxygen supplementation, and dietary modifications, was associated with favourable outcomes and the lowest mortality. In contrast, surgical intervention, often necessitated by suspected ischemia or perforation, was associated with significantly higher morbidity and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Pneumatosis intestinalis in systemic sclerosis is a complex clinical entity demanding a nuanced, multi\u2010disciplinary approach to management. Non\u2010operative management should remain the cornerstone of treatment for clinically stable presentations, with surgery reserved for those with clear indications. The absence of standardised guidelines underscores the need for further research to refine diagnostic criteria and therapeutic protocols, ultimately improving long\u2010term outcomes in this complex intersection of gastrointestinal and systemic disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ans.70001","type":"journal-article","created":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T04:34:26Z","timestamp":1738643666000},"page":"1718-1724","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Pneumatosis intestinalis in systemic sclerosis: navigating diagnostic and therapeutic challenges"],"prefix":"10.1111","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3601-4741","authenticated-orcid":false,"given":"Shalvin","family":"Jassal","sequence":"first","affiliation":[{"name":"Upper Gastrointestinal Surgery Unit Eastern Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ishani","family":"Oza","sequence":"additional","affiliation":[{"name":"Upper Gastrointestinal Surgery Unit Eastern Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3434-2532","authenticated-orcid":false,"given":"William C.","family":"Gibcus","sequence":"additional","affiliation":[{"name":"Upper Gastrointestinal Surgery Unit Eastern Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1835-3478","authenticated-orcid":false,"given":"Melanie","family":"Crispin","sequence":"additional","affiliation":[{"name":"Upper Gastrointestinal Surgery Unit Eastern Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,4]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"213","article-title":"Aer intestinorum tam sub extima quam intimatunica inclusus: Observationes anatomicae","volume":"5","author":"Du Vernoy JG","year":"1730","journal-title":"Comment. Acad. Sci. Imp. Petropol."},{"key":"e_1_2_8_3_1","first-page":"575","article-title":"Gastrointestinal complications in systemic sclerosis: a review of pathophysiology, diagnosis, and management","volume":"30","author":"Matucci\u2010Cerinic M","year":"2018","journal-title":"Curr. Opin. Rheumatol."},{"key":"e_1_2_8_4_1","first-page":"44","article-title":"Gastrointestinal manifestations of systemic sclerosis: pathogenesis and management","volume":"21","author":"Volkmann ER","year":"2019","journal-title":"Curr. Rheumatol. Rep."},{"key":"e_1_2_8_5_1","article-title":"Gastrointestinal manifestations in systemic sclerosis: from pathogenesis to management","volume":"20","author":"Mari\u00f1o M","year":"2021","journal-title":"Autoimmun. Rev."},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/2474515"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2018-225175"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcr222"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000441-200608000-00011"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbspin.2007.08.004"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.3109\/s10165-011-0551-3"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2018-225068"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2006.08.025"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/RHU.0b013e3181ffeb49"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1259\/0007-1285-42-501-701"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.115.2.300"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-5994.2011.02557.x"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-017-3668-7"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.legalmed.2014.08.005"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2018-eular.2085"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2019.01.037"},{"key":"e_1_2_8_22_1","first-page":"1051","article-title":"Pneumatosis intestinalis secondary to scleroderma","volume":"68","author":"Kwok A","year":"2020","journal-title":"J. Invest. Med."},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2015.12.007"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.32.607"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/0049-0172(90)90049-L"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kead104.269"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amsu.2017.09.010"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.27393"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.100254"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.56.7877"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000015480"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/987410"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1970.03170190082021"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.14309\/01.ajg.0000785836.03125.7d"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keab190"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clim.2023.109267"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0755-4982(06)74930-2"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.14309\/01.ajg.0000713116.42983.42"},{"key":"e_1_2_8_39_1","first-page":"e27200","article-title":"Pneumatosis intestinalis, pneumoperitoneum, and ascites secondary to scleroderma: a case report","volume":"14","author":"McCormack SM","year":"2022","journal-title":"Cureus"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.4240\/wjgs.v15.i4.553"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-018-0794-y"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02554132"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rcl.2021.03.012"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-018-4977-8"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.14309\/00000434-200709002-00538"},{"key":"e_1_2_8_46_1","volume-title":"StatPearls [Internet]","author":"Im J","year":"2021"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.4046\/trd.2014.77.5.219"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1159\/000236596"}],"container-title":["ANZ Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.70001","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ans.70001","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.70001","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T11:41:56Z","timestamp":1772970116000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ans.70001"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,4]]},"references-count":47,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1111\/ans.70001"],"URL":"https:\/\/doi.org\/10.1111\/ans.70001","archive":["Portico"],"relation":{},"ISSN":["1445-1433","1445-2197"],"issn-type":[{"value":"1445-1433","type":"print"},{"value":"1445-2197","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,4]]},"assertion":[{"value":"2024-12-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}