Free air intraperitoneally during chemotherapy for acute lymphoblastic leukemia: consider pneumatosis cystoides intestinalis.
Intraperitoneal free air in a child with acute lymphoblastic leukemia (ALL) treated with induction chemotherapy is an ominous sign suspective of gastrointestinal perforation. We report a case of pneumatosis cystoides intestinalis (PCI) with free intraperitoneal air without bowel perforation in a child with Down syndrome during ALL induction treatment. PCI is a physical sign characterized by gas-filled cysts of the submucosa or subserosa of the bowel that can lead to pneumoperitoneum. Clinical management of this case in respect to reported literature on PCI and specific characteristics of patients treated with ALL induction chemotherapy are discussed.
Groninger
Ellis
E
Department of Pediatric Oncology/Hematology of the Beatrix Children's Hospital, University of Groningen, The Netherlands. E.Groninger@ozg.eu
Hulscher
Jan B F
JB
Timmer
Bert
B
Tamminga
Rienk Y J
RY
Broens
Paul M A
PM
D002675:Child, Preschool; D005260:Female; D006801:Humans; D011006:Pneumatosis Cystoides Intestinalis / Q000209:etiology* / Q000523:psychology / Q000628:therapy; D011027:Pneumoperitoneum / Q000209:etiology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*