Pneumatosis intestinalis in children with leukaemia: Report of three cases

Abstract

Three children with leukaemia (one with acute myeloid, two with acute lymphoblastic leukaemia) developed pneumatosis intestinalis during cytostatic treatment. The aetiology of pneumatosis intestinalis in these children could not be elucidated. Pneumatosis intestinalis may be caused by entry of gas into a bowel wall which is altered by steroid or cytostatic treatment. Otherwise, anaerobic bacteria may produce gas in the intestinal walls, therefore we treated all children with metronidazole.

Gastrointestinal complications in children with acute myeloid leukemia

“…That patient had received vincristine, daunorubicin, thioguanine, and cytarabine. The diagnosis was made with plain radiographs and the pneumatosis resolved with antibiotics [69]. There appears to be insufficient evidence to guide the management of pneumatosis intestinalis in pediatric patients with AML.…”

Medication-induced Pneumatosis Intestinalis

“…Reports of successful treatment of PI in adults [13][14][15][16][17] and children 8,18 with metronidazole led to its use in our patient. This patient had had loose stools for so long that it had become "normal" for him and was rarely discussed at his periodic visits.…”

Pneumatosis intestinalis (PI) following severe traumatic brain injury

“…It has been reported that decreasing the total amount of sorbitol is the first step in the treatment of PI [6,12]. Metronidazole is effective for treatment of both adults and children with PI [14][15][16]. Antibiotics for prevention and treatment of necrotizing enterocolitis are also important with clinical correlation.…”