[Pneumatosis intestinalis in 9 children with an oncologic disease].
OBJECTIVE
To acquire knowledge regarding the rare condition pneumatosis intestinalis (PI) in children treated for malignant disease.


METHODS
Retrospective.


METHODS
In 1998-1999 PI was diagnosed in 9 of the 140 children with malignant disease in the department of Paediatric Oncology of the UMC St Radboud, Nijmegen, the Netherlands. By examination of the records of these 9 children, data were collected on the symptomatology, diagnostics, treatment and prognosis of PI.


RESULTS
The 9 children included 7 boys and 2 girls, varying in age from 2 to 12 years. In 7 patients the underlying disease was acute lymphocytic leukaemia and in 2 it was a stage IV neuroblastoma. The presenting symptoms were nonspecific and included: a distended abdomen, abdominal pain, diarrhoea and constipation. In all children, PI was located in the colon. Supplemental blood and microbiological analysis did not reveal any typical abnormalities. 8 children were treated with lactitol because of constipation. A laparotomy was performed in the first patient, while the other 8 were treated with gastric suctioning, parenteral nutrition and antibiotics. All 9 children recovered within a few weeks.


CONCLUSIONS
With supportive care, PI in children with malignant disease is mostly a self-limiting condition. A pneumoperitoneum in PI is no indication for surgery, except in the presence of an acute abdomen. Chemotherapy can be continued.
Kyrieleis
H A C
HA
Afd. Kindergeneeskunde, Universitair Medisch Centrum St Radboud, Postbus 910o, 6500 HB Nijmegen. h.kyrieleis@cukz.umcn.nl
Wilsterman
M E F
ME
Severijnen
R S V M
RS
van Die
C E
CE
Bongaerts
G P A
GP
Gidding
C E M
CE
D000970:Antineoplastic Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D009447:Neuroblastoma / Q000150:complications* / Q000188:drug therapy; D011006:Pneumatosis Cystoides Intestinalis / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000188:drug therapy; D011379:Prognosis; D012189:Retrospective Studies
D000970:Antineoplastic Agents