Handa Atsuhiko, Nozaki Taiki, Makidono Akari, Okabe Tetsuhiko, Morita Yuka, Fujita Kazutoshi, Matsusako Masaki, Kono Tatsuo, Kurihara Yasuyuki, Hasegawa Daisuke, Kumamoto Tadashi, Ogawa Chitose, Yuza Yuki, Manabe Atsushi
Department of Radiology, St Luke's International Hospital, Tokyo, Japan.
Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
Pediatr Int. 2019 Feb;61(2):122-139. doi: 10.1111/ped.13755. Epub 2019 Feb 7.
Children with cancer are at increased risk of life-threatening emergencies, either from the cancer itself or related to the cancer treatment. These conditions need to be assessed and treated as early as possible to minimize morbidity and mortality. Cardiothoracic emergencies encompass a variety of pathologies, including pericardial effusion and cardiac tamponade, massive hemoptysis, superior vena cava syndrome, pulmonary embolism, and pneumonia. Abdominal emergencies include bowel obstruction, intussusception, perforation, tumor rupture, intestinal graft-versus-host disease, acute pancreatitis, neutropenic colitis, and obstructive uropathy. Radiology plays a vital role in the diagnosis of these emergencies. We here review the clinical features and imaging in pediatric patients with oncologic emergencies, including a review of recently published studies. Key radiological images are presented to highlight the radiological approach to diagnosis. Pediatricians, pediatric surgeons, and pediatric radiologists need to work together to arrive at the correct diagnosis and to ensure prompt and appropriate treatment strategies.
患有癌症的儿童面临危及生命的紧急情况的风险增加,这些情况要么源于癌症本身,要么与癌症治疗相关。这些病症需要尽早评估和治疗,以尽量减少发病率和死亡率。心胸外科急症包括多种病理情况,如心包积液和心脏压塞、大量咯血、上腔静脉综合征、肺栓塞和肺炎。腹部急症包括肠梗阻、肠套叠、穿孔、肿瘤破裂、肠道移植物抗宿主病、急性胰腺炎、中性粒细胞减少性结肠炎和梗阻性尿路病。放射学在这些急症的诊断中起着至关重要的作用。我们在此回顾儿科肿瘤急症患者的临床特征和影像学表现,包括对近期发表研究的综述。展示关键的放射影像以突出诊断的放射学方法。儿科医生、儿科外科医生和儿科放射科医生需要共同努力以做出正确诊断并确保及时、恰当的治疗策略。