title: Ultrasound in the management of hepatic veno-occlusive disease in three children treated with dactinomycin and vincristine.
abstract: Three children, treated with dactinomycin and vincristine without radiotherapy showed hepatic toxicity consistent with diagnostic criteria for hepatic veno-occlusive disease (VOD). Two patients were affected with Wilms' tumor and the third with malignant fibromatosis. The clinical manifestations of VOD were mild and regressed in all patients after supportive therapy. Serial ultrasonography (US) was performed in all cases and was useful in confirming the diagnosis and in evaluating the severity of the disease. US features of VOD were hepatomegaly, gallbladder wall thickening, ill-defined borders of the hepatic vessels, and ascites. Parenchymal heterogeneity was still present after several months as a result of the hepatic injury. The hazy appearance of the portal vessels and the gallbladder wall thickening seemed directly correlated with the degree of hepatic involvement in the early phase of VOD.
authors.affiliation: Department of Pediatrics, University La Sapienza, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Schiavetti
authors.forename: M
authors.initials: M
authors.lastname: Matrunola
authors.forename: G
authors.initials: G
authors.lastname: Varrasso
authors.forename: A
authors.initials: A
authors.lastname: Padula
authors.forename: M A
authors.initials: MA
authors.lastname: Castello
mesh_terms: D002648:Child; D002675:Child, Preschool; D003609:Dactinomycin / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006504:Hepatic Veno-Occlusive Disease / Q000000981:diagnostic imaging / Q000188:drug therapy; D006801:Humans; D008297:Male; D019384:Nucleic Acid Synthesis Inhibitors / Q000627:therapeutic use*; D011379:Prognosis; D014463:Ultrasonography; D014750:Vincristine / Q000627:therapeutic use*
chemical_list: D019384:Nucleic Acid Synthesis Inhibitors; D003609:Dactinomycin; D014750:Vincristine