title: A severe case of pneumatosis cystoides intestinalis with massive accumulation of gas outside the gastrointestinum.
abstract: We report an unusually severe case of pneumatosis cystoides intestinalis in an adult female patient undergoing chemotherapy for lymphoblastic crisis in chronic myelogenous leukemia. An impressive accumulation of gas was not only detected within the intestinal wall and mesentery but also in the peritoneum, retroperitoneum, mediastinum and cervical subcutaneous tissue. The patient was almost asymptomatic and fully recovered within a few days of treatment. In addition to chemotherapy, the patient was receiving trimethoprim/sulfamethoxazole for pneumocystis carinii pneumonia and lactulose for constipation. Mucosal damage due to chemotherapy and depletion of tetrahydrofolic acid, changes in bowel flora induced by antibiotic treatment, and the intake of unabsorbable carbohydrates may be responsible for the severity of the disease.
authors.affiliation: Klinikum der Ludwig-Maximilians-Universität München, Medizinische Poliklinik - Innenstadt. tato@pk-i.med.uni-muenchen.de
authors.forename: F
authors.initials: F
authors.lastname: Tatò
authors.forename: M
authors.initials: M
authors.lastname: Mack
authors.forename: O
authors.initials: O
authors.lastname: Meissner
authors.forename: D
authors.initials: D
authors.lastname: Schlöndorff
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D001752:Blast Crisis / Q000188:drug therapy; D005260:Female; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy; D011006:Pneumatosis Cystoides Intestinalis / Q000139:chemically induced / Q000000981:diagnostic imaging*; D011027:Pneumoperitoneum / Q000139:chemically induced / Q000000981:diagnostic imaging*; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D015662:Trimethoprim, Sulfamethoxazole Drug Combination