title: Acute colonic pseudo-obstruction complicating chemotherapy in paediatric oncohaematological patients: clinical and imaging features.
abstract: OBJECTIVE
  Although acute colonic pseudo-obstruction (ACPO) complicating chemotherapy is still a controversial entity, it is one with which radiologists should be familiar. We describe the imaging features of ACPO in children following chemotherapy for treatment of a haematological malignancy.
  
  
  METHODS
  We retrospectively reviewed the imaging features of eight children (age 3-14 years) with chemotherapy-related ACPO, all of whom had undergone plain radiography and CT examinations. The diagnosis of ACPO was based on both clinical features and imaging findings.
  
  
  RESULTS
  Abnormalities noted on plain radiography included faecal gaseous distension of the transverse colon (4/8), faecal gaseous distension of the ascending colon (3/8), gaseous distended transverse colon (3/8) and gaseous small bowel loops (6/8). As seen on CT scans, findings of faecal fluid distended the ascending and transverse colon (5/8), faecal gas distended the transverse and ascending colon (3/8), and small bowel dilatation (5/8) and pneumatosis intestinalis (2/8) were noted. Seven of the eight patients had colonic dilatation from the caecum to the transverse colon with the transition zone near the splenic flexure.
  
  
  CONCLUSIONS
  In children presenting with abdominal pain and constipation following chemotherapy, imaging features of progressive colonic dilatation seen on radiography and dilatation from the caecum to the transverse colon with the transition zone near the splenic flexure, as noted on CT, are suggestive of ACPO. CT is more successful than plain radiography for evaluating this finding, particularly in colonic segments filled primarily with fluid, but CT should not be necessary for making the diagnosis as plain radiographs and clinical evaluation should be adequate.
authors.affiliation: Department of Radiology, St Mary's Hospital, the Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: G E
authors.initials: GE
authors.lastname: Lee
authors.forename: G-Y
authors.initials: GY
authors.lastname: Lim
authors.forename: J-W
authors.initials: JW
authors.lastname: Lee
authors.forename: B
authors.initials: B
authors.lastname: Cho
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003106:Colon / Q000000981:diagnostic imaging; D003112:Colonic Pseudo-Obstruction / Q000139:chemically induced* / Q000000981:diagnostic imaging*; D005260:Female; D005740:Gases; D006801:Humans; D007938:Leukemia / Q000188:drug therapy*; D008223:Lymphoma / Q000188:drug therapy*; D008297:Male; D011006:Pneumatosis Cystoides Intestinalis / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D000970:Antineoplastic Agents; D005740:Gases