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Acute colonic pseudo-obstruction complicating chemotherapy in paediatric oncohaematological patients: clinical and imaging features.
MedLine Citation:
PMID:  21828148     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background: Although acute colonic pseudo-obstruction (ACPO) complicating chemotherapy is still a controversial entity, it is one with which radiologists should be familiar. We describe the imaging features of ACPO in children following chemotherapy for treatment of a haematological malignancy. Methods: We retrospectively reviewed the imaging features of 8 children (age 3-14 years) with chemotherapy-related ACPO, all of whom had undergone plain radiography and CT examinations. The diagnosis of ACPO was based on both clinical features and imaging findings. Results: Abnormalities noted on plain radiography included faecal gaseous distension of the transverse colon (4/8), faecal gaseous distension of the ascending colon (3/8), gaseous distended transverse colon (3/8) and gaseous small bowel loops (6/8). As seen on CT scans, findings of faecal fluid distended ascending and transverse colon (5/8), faecal gas distended transverse and ascending colon (3/8), small bowel dilatation (5/8) and pneumatosis intestinalis (2/8) were noted. Seven of the eight patients had colonic dilatation from the caecum to the transverse colon with the transition zone near the splenic flexure. Conclusion: In children presenting with abdominal pain and constipation following chemotherapy, imaging features of progressive colonic dilatation seen on radiography and dilatation from the caecum to the transverse colon with the transition zone near the splenic flexure, as noted on CT, are suggestive of ACPO. CT is more successful than plain radiography for evaluating this finding, particularly in colonic segments filled primarily with fluid, but CT should not be necessary for making the diagnosis as plain radiographs and clinical evaluation should be adequate.
Authors:
G E Lee; G-Y Lim; J-W Lee; B Cho
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-8-9
Journal Detail:
Title:  The British journal of radiology     Volume:  -     ISSN:  1748-880X     ISO Abbreviation:  -     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-8-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0373125     Medline TA:  Br J Radiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Departments of Radiology, St Mary's Hospital, the Catholic University of Korea Seoul Korea.
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