Kirchner J, Seipelt G, Heyd R, Dietrich C F, Jacobi V
Institut für Allgemeine Röntgendiagnostik, Universität Frankfurt/Main.
Dtsch Med Wochenschr. 1996 Oct 18;121(42):1288-91. doi: 10.1055/s-2008-1043141.
A 58-year-old man was treated for abdominal and inguinal recurrence of a centroblastic non-Hodgkin lymphoma with high doses of methotrexate and cytosine arabinoside. A chest radiogram, taken on the 18th day of chemotherapy to exclude pulmonary infiltration, revealed pneumoperitoneum. The patients's complaints were merely of abdominal fullness and persisting diarrhoea. His general state was hardly impaired, the abdomen soft on palpation with active peristalsis.
There was aplastic anaemia (haemoglobin 9.9 g/dl, erythrocytes 3.4 x 10(6)/microliters, white cells 1000/microliters, platelets 20,000/microliters. Plain film of the abdomen and abdominal computed tomography confirmed pneumoperitoneum. Intraluminal air had caused wall dissection in the ascending and transverse colon (pneumatosis coli as cause of the pneumoperitoneum).
There was complete absorption of the free abdominal air by the 29th day of chemotherapy under parenteral nutrition and metronidazole (3 x 500 mg daily).
一名58岁男性因中心母细胞性非霍奇金淋巴瘤腹部及腹股沟复发，接受了大剂量甲氨蝶呤和阿糖胞苷治疗。化疗第18天拍摄胸部X光片以排除肺部浸润，结果显示存在气腹。患者仅主诉腹部胀满及持续性腹泻。其一般状况几乎未受影响，腹部触诊柔软，肠蠕动活跃。
存在再生障碍性贫血（血红蛋白9.9 g/dl，红细胞3.4×10⁶/微升，白细胞1000/微升，血小板20,000/微升）。腹部平片及腹部计算机断层扫描证实存在气腹。肠腔内气体导致升结肠和横结肠壁分离（结肠积气是气腹的原因）。
在接受肠外营养及甲硝唑（每日3次，每次500毫克）治疗的情况下，化疗第29天时腹腔内游离气体完全吸收。
