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Publication year
2005Source
Nederlands Tijdschrift voor Geneeskunde, 149, 12, (2005), pp. 647-52ISSN
Publication type
Article / Letter to editor
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Organization
Paediatric Surgery
Radiology
Medical Microbiology
Paediatrics - OUD tm 2017
Journal title
Nederlands Tijdschrift voor Geneeskunde
Volume
vol. 149
Issue
iss. 12
Page start
p. 647
Page end
p. 52
Subject
UMCN 1.1: Functional Imaging; UMCN 1.4: Immunotherapy, gene therapy and transplantation; UMCN 4.1: Microbial pathogenesis and host defense; UMCN 4.3: Tissue engineering and reconstructive surgeryAbstract
OBJECTIVE: To acquire knowledge regarding the rare condition pneumatosis intestinalis (PI) in children treated for malignant disease. DESIGN: Retrospective. METHOD: 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. CONCLUSION: 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.
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- Faculty of Medical Sciences [90373]
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