Reuss M, Wagner K, Klier R, Saal J G, Waller H D
Abteilung Innere Medizin II, Medizinischen Universitätsklinik, Tübingen.
Dtsch Med Wochenschr. 1991 Apr 5;116(14):535-9. doi: 10.1055/s-2008-1063644.
Recurring paroxysmal abdominal pain developed in a 19-year old woman suffering from acute lymphatic T-cell leukaemia, during induction chemotherapy with cyclophosphamide, cytarabine and mercaptopurine. Both the plain radiograph and CT of the abdomen showed pathognomonic intramural gas accumulations and free air below the right diaphragm, pointing to pneumatosis coli. There was marked pancytopenia (leucocytes 800/microliters,haemoglobin 7.6 g/dl, thrombocytes 10,000/microliters). Whereas the abdominal pain subsided rapidly under oxygen therapy and liquid nourishment, the radiological changes receded gradually. However, fever and diarrhoeas occurred subsequently. Fever persisted for 3 weeks despite treatment with antibiotics (three times 60 mg/d gentamicin, three times 2 g/d mefoxitin and three times 500 mg/d metronidazole, and later 30 mg/d amphotericin B) and subsided only after completion of the induction chemotherapy and an increase of leucocyte count.
一名19岁患急性T细胞淋巴细胞白血病的女性在接受环磷酰胺、阿糖胞苷和巯嘌呤诱导化疗期间出现反复阵发性腹痛。腹部平片和CT均显示特征性的肠壁内气体积聚以及右膈下的游离气体，提示结肠积气。患者有明显的全血细胞减少（白细胞800/微升，血红蛋白7.6克/分升，血小板10000/微升）。尽管在吸氧治疗和液体营养支持下腹痛迅速缓解，但影像学改变逐渐消退。然而，随后出现发热和腹泻。尽管使用了抗生素治疗（每日三次60毫克庆大霉素、每日三次2克美洛西林和每日三次500毫克甲硝唑，后来每日30毫克两性霉素B），发热仍持续了3周，直到诱导化疗结束且白细胞计数增加后才消退。
