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Pneumatosis intestinalis in children with acute lymphoblastic leukemia and acute myeloid leukemia

Siyang Li1, Jeffrey Traubici, Marie-Chantal Ethier

  • 1Child Health Evaluative Sciences, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada.

Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer
|January 15, 2011
PubMed

Insights

Pneumatosis intestinalis (PI) is rare in children with acute lymphoblastic leukemia (ALL) or acute myeloid leukemia (AML). Conservative management, including bowel rest and antibiotics, led to excellent outcomes for most pediatric cancer patients with PI.

Area of Science:

  • Pediatric Oncology
  • Gastroenterology
  • Radiology

Background:

  • Pneumatosis intestinalis (PI) is a rare condition characterized by gas in the bowel wall.
  • Pediatric patients undergoing treatment for acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) are susceptible to various complications.
  • Understanding PI in this specific population is crucial for timely diagnosis and management.

Purpose of the Study:

  • To describe the clinical presentation, diagnostic findings, treatment strategies, and outcomes of pneumatosis intestinalis in pediatric patients with ALL and AML.
  • To evaluate the diagnostic accuracy of different imaging modalities for PI in this cohort.
  • To identify factors influencing outcomes in pediatric leukemia patients with PI.

Main Methods:

  • Retrospective chart review of 514 pediatric patients (≤18 years) diagnosed with ALL or AML between 1999 and 2007.
  • Identification of PI episodes through radiology report reviews.
  • Analysis of patient demographics, leukemia type, time to PI diagnosis, imaging findings, treatments, and outcomes.

Main Results:

  • Thirty-one PI episodes were identified in 24 pediatric patients (20 with ALL, 4 with AML).
  • The median time from leukemia diagnosis to PI was 1.0 month; PI occurred predominantly in the colon.
  • Plain radiographs were diagnostic for all PI episodes; conservative management (bowel rest, antibiotics) was effective, with no PI-related fatalities.

Conclusions:

  • Pneumatosis intestinalis is an uncommon but significant complication in pediatric patients with ALL and AML.
  • Plain radiography is a reliable diagnostic tool for PI, while ultrasound may be less sensitive.
  • Conservative management strategies are generally effective, leading to favorable outcomes in most cases.
Abstract

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