Biçakçi Zafer, Akyay Arzu, Oztürkmen Seda, Celebi-Tayfur Asli, Ağladioğlu Sebahat, Ciledağ Nazan, Ozçay Figen, Arda Kemal, Olcay Lale
Department of Pediatric Hematology, Dr. A.Y. Ankara Oncology Training and Research Hospital, Ankara, Turkey.
Turk J Pediatr. 2011 Sep-Oct;53(5):579-82.
A 5(3/12)-year-old boy with Philadelphia chromosome (+) pre-B acute lymphoblastic leukemia (ALL) without extramedullary involvement did not achieve remission after induction therapy. His family stopped therapy, but he was readmitted eight months later due to pyoderma, pneumonia and active leukemia with leukocytosis. During cytoreductive and antibiotic therapy, he developed progressive abdominal distension, pain, globe vesicale, tachypnea, and respiratory alkalosis. Bowel sounds could not be auscultated. Dilation, mainly in the large intestine, was detected radiologically. His neurological examination revealed absence of superficial reflexes and hypoesthesia along with normal motor strength and deep tendon reflexes in the lower extremities, consistent with conus medullaris syndrome, which was thought to give rise to acute colonic pseudo-obstruction.
一名5（3/12）岁患有费城染色体（+）的前体B细胞急性淋巴细胞白血病（ALL）且无髓外浸润的男孩在诱导治疗后未达到缓解。其家人停止了治疗，但8个月后他因脓疱病、肺炎和伴有白细胞增多的活动性白血病再次入院。在进行细胞减灭和抗生素治疗期间，他出现了进行性腹胀、疼痛、膀胱膨胀、呼吸急促和呼吸性碱中毒。未闻及肠鸣音。影像学检查发现主要在大肠出现扩张。他的神经系统检查显示浅反射消失、感觉减退，同时下肢肌力正常、深腱反射正常，符合圆锥马尾综合征，被认为是导致急性结肠假性梗阻的原因。
