title: Pneumatosis intestinalis following cytotoxic or immunosuppressive treatment.
abstract: Pneumatosis intestinalis (PI) is an uncommon condition characterized by the presence of gas within the bowel wall. We describe 5 cases of PI that occurred after cytotoxic or immunosuppressive treatment for hematological disorders. All patients were neutropenic shortly before or at the time of diagnosis of PI, but did not show specific symptoms. The diagnosis was made by conventional X-ray and confirmed by abdominal computed tomography. Since there were no signs of secondary complications such as peritonitis, ischemia, or perforation, conservative treatment with broad-spectrum antibiotics and parenteral nutrition was initiated. All patients but 1 achieved complete resolution of PI after recovery from myelosuppression. Benign pneumoperitoneum due to PI should be considered in the differential diagnosis of free intra-abdominal air after chemotherapeutic or immunosuppressive therapy. It can be managed successfully by conservative treatment in the absence of secondary complications, if there is recovery of myelopoiesis.
authors.affiliation: Medizinische Klinik IV, RWTH Aachen, Deutschland.
authors.forename: O
authors.initials: O
authors.lastname: Galm
authors.forename: U
authors.initials: U
authors.lastname: Fabry
authors.forename: G
authors.initials: G
authors.lastname: Adam
authors.forename: R
authors.initials: R
authors.lastname: Osieka
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D005260:Female; D006402:Hematologic Diseases / Q000188:drug therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D019891:Leukopoiesis / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D011006:Pneumatosis Cystoides Intestinalis / Q000139:chemically induced* / Q000000981:diagnostic imaging; D011027:Pneumoperitoneum / Q000139:chemically induced* / Q000000981:diagnostic imaging; D011859:Radiography
chemical_list: D000970:Antineoplastic Agents; D007166:Immunosuppressive Agents