Tjon A Tham R T, Vlasveld L T, Willemze R
Department of Diagnostic Radiology, University Medical Centre, Leiden, The Netherlands.
AJR Am J Roentgenol. 1990 Jan;154(1):95-8. doi: 10.2214/ajr.154.1.2104733.
We analyzed the findings on plain abdominal radiographs in 24 patients who had adverse gastrointestinal reactions after chemotherapy with cytosine-arabinoside (Ara-C) for treatment of acute leukemia or non-Hodgkin lymphoma. Ara-C was given with vincristine, VP 16-213, daunorubicin, amsacrine, adriamycin, or corticosteroids in various combinations and dosages. The abnormalities noted on plain abdominal radiographs included paralytic ileus (73%), cecal distension (38%), pneumatosis intestinalis (27%), thickened loops of small bowel (19%), and pneumoperitoneum (8%). One patient had small-bowel ileus simulating an obstruction. In 23%, death was directly related to gastrointestinal complications. Bowel wall erosions, necrosis, and transmural or submucosal hemorrhage were the main findings at autopsy. This experience suggests that plain abdominal radiographs are useful in the diagnosis of gastrointestinal complications associated with chemotherapy with Ara-C.
我们分析了24例在使用阿糖胞苷（Ara-C）化疗治疗急性白血病或非霍奇金淋巴瘤后出现不良胃肠道反应的患者的腹部平片检查结果。Ara-C与长春新碱、VP 16-213、柔红霉素、安吖啶、阿霉素或皮质类固醇以各种组合和剂量联合使用。腹部平片上发现的异常包括麻痹性肠梗阻（73%）、盲肠扩张（38%）、肠壁积气（27%）、小肠肠袢增厚（19%）和气腹（8%）。1例患者有类似肠梗阻的小肠梗阻。23%的患者死亡与胃肠道并发症直接相关。尸检的主要发现为肠壁糜烂、坏死以及透壁或黏膜下出血。这一经验表明，腹部平片对诊断与Ara-C化疗相关的胃肠道并发症有用。
