Necrotizing enterocolitis in acute leukemia: radiographic findings

Acute gangrenous appendicitis or right lower quadrant necrotizing enterocolitis occurs with a high incidence in patients undergoing treatment for acute leukemia. In a series of 81 fully documented cases with complete charts and follow-up we identified seven surgically or pathologically proved cases of this syndrome. Plain radiographs of the abdomen were available in five of the seven cases, and a barium enema was performed on one. In three of the five cases the radiographic examination suggested or confirmed the nature of the right lower quadrant syndrome. Two of the seven patients were sucessfully treated by appropriate surgery. The radiographic findings in this series are reviewed and re-emphasized since an accurate diagnosis becomes important in appropriate management of this formerly uniformly fatal complication of acute leukemia and/or its therapy.