Barium Enema Septicemia

Richman, Lawrence S.; Short, Welland F.; Cooper, William

doi:10.1001/jama.1973.03230010038008

Cited by 24 publications

(2 citation statements)

References 3 publications

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“…The thickened cecum is usually isodense compared to surrounding normal bowel but may have hypodense areas presumably from edema, hemorrhage, or necrosis 65 . A barium enema may demonstrate cecal distortion with edema and effacement of the mucosa, rigidity, loss of haustral markings, thumb printing, and occasionally pericecal abscess or fistulation 67,68 although it must be done carefully so as not to precipitate cecal perforation 69 or septicemia 70 . A 67 Ga radionuclide scan may show uptake in the right lower quadrant, although there may also be activity in the gastrointestinal tract, the liver, and the spleen.…”

Section: Neutropenic Enterocolitismentioning

confidence: 99%

Gastrointestinal manifestations of leukemia

Ebert

Hagspiel

2012

J of Gastro and Hepatol

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Gastrointestinal (GI) manifestations of leukemia occur in up to 25% of patients at autopsy, generally during relapse. Its presence varies with the type of leukemia and has been decreasing over time due to improved chemotherapy. Gross leukemic lesions are most common in the stomach, ileum, and proximal colon. Leukemia in the esophagus and stomach includes hemorrhagic lesions from petechiae to ulcers, leukemic infiltrates, pseudomembranous esophagitis, and fungal esophagitis. Lesions in the small and large bowel are usually hemorrhagic or infiltrative. Infiltration of lymphoreticular organs, mainly spleen, liver, and lymph nodes, is more prominent in chronic than acute leukemia. Neutropenic enterocolitis, a necrotizing process involving the cecum, ascending colon, and terminal ileum, is increasing in incidence due to greater intensity of chemotherapy. Distension of bowel leads to mucosal breaches, permitting entry of organisms that grow profusely in the absence of neutrophils. Ischemic necrosis follows, leading to perforation and/or peritonitis. Patients present with fever, abdominal pain, diarrhea, nausea, vomiting, abdominal distension and tenderness. Ultrasound and computed tomography scans show thickening of the bowel wall. Treatment is supportive with surgery for necrosis and perforation. The main GI causes of death in leukemia are hemorrhage, infection, and necrotizing enterocolitis.

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Section: Neutropenic Enterocolitismentioning

confidence: 99%

Gastrointestinal manifestations of leukemia

Ebert

Hagspiel

2012

J of Gastro and Hepatol

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“…Very rare cases of septicemia following barium enema have been reported in the literature. One case of fatal septicemia was reported in a 51‐year‐old man with acute leukemia, 5 as well as two cases of septicemia in a previously healthy 7‐week‐old male infant and a 64‐year‐old man 6,7 …”

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confidence: 99%