Picardi M, Selleri C, Camera A, Catalano L, Rotoli B
Division of Hematology, Federico II University Medical School, Naples, Italy.
Haematologica. 1999 Mar;84(3):222-5.
Acute leukemia patients may develop life-threatening gut complications after intensive chemotherapy. We evaluated the role of abdominal and pelvic ultrasound (US) examination in early detection of these complications.
A cohort of twenty adult acute leukemia patients undergoing intensive chemotherapy for remission induction entered the study. All chemotherapy regimens included cytarabine by continuous i.v. infusion for several days.
Three patients had severe gut complications: 2 cases of enterocolitis and 1 case of gall bladder overdistension in the absence of calculi. In all cases the abnormality was documented by US examination: US scan showed thickening of the intestinal wall (two cases), and gall bladder overdistension with biliary sludge (one case). Immediate medical care included bowel rest, a broad-spectrum antibiotic, antimycotic treatment, and granulocyte colony-stimulating factor. All patients recovered from the complication.
We believe that the favorable outcome obtained in our small series can be attributed to early diagnosis followed by appropriate treatment. Early recognition by US and immediate medical management can lead to complete recovery of severe intestinal complications in patients with acute leukemia undergoing intensive chemotherapy.
急性白血病患者在强化化疗后可能会出现危及生命的肠道并发症。我们评估了腹部和盆腔超声（US）检查在早期发现这些并发症中的作用。
二十名接受强化化疗以诱导缓解的成年急性白血病患者进入该研究。所有化疗方案均包括连续静脉输注阿糖胞苷数天。
三名患者出现严重肠道并发症：2例小肠结肠炎和1例无结石的胆囊过度扩张。在所有病例中，异常情况均通过超声检查记录：超声扫描显示肠壁增厚（2例），以及胆囊伴有胆汁淤积的过度扩张（1例）。立即的医疗护理包括肠道休息、广谱抗生素、抗真菌治疗和粒细胞集落刺激因子。所有患者均从并发症中康复。
我们认为，在我们的小样本系列中获得的良好结果可归因于早期诊断并随后进行适当治疗。超声早期识别并立即进行医疗管理可使接受强化化疗的急性白血病患者的严重肠道并发症完全康复。
