一名2岁女童在异基因骨髓移植后发生肠壁囊样积气并伴有腹腔游离气体。

Pneumatosis cystoides intestinalis with abdominal free air in a 2-year-old girl after allogeneic bone marrow transplantation.

作者信息

Takanashi M, Hibi S, Todo S, Sawada T, Tsunamoto K, Imashuku S

机构信息

Department of Pediatrics, Kyoto Prefectural University of Medicine, Japan.

出版信息

Pediatr Hematol Oncol. 1998 Jan-Feb;15(1):81-4. doi: 10.3109/08880019809009512.

DOI:10.3109/08880019809009512

PMID:9509510

Abstract

A 2-year-old girl with acute lymphoblastic leukemia (ALL) showing a t(4;11)(q21;q23) karyotype underwent allogeneic bone marrow transplantation (BMT) with the conditioning regimen of L-PAM (70 mg/m2/d for 3 days), busulfan (140 mg/m2/d for 2 days), and total body irradiation (12 Gy). On day 57, the patient developed pneumatosis cystoides intestinalis (PCI) when she received cyclosporin A and corticosteroids for graft-versus-host disease (GVHD). Because of the presence of massive abdominal free air and the suspicion of peritonitis, she underwent surgical intervention, which, however, revealed neither intestinal perforation nor peritoneal infection. She recovered from PCI in 10 days with nasogastric suction, fasting, and systemic broad-spectrum antibiotics. PCI with massive abdominal free air after BMT should be manageable by conservative therapy alone.

摘要

一名患有急性淋巴细胞白血病（ALL）且核型为t(4;11)(q21;q23)的2岁女孩接受了异基因骨髓移植（BMT），预处理方案为左旋苯丙氨酸氮芥（70 mg/m²/天，共3天）、白消安（140 mg/m²/天，共2天）及全身照射（12 Gy）。在第57天，患者在接受环孢素A和皮质类固醇治疗移植物抗宿主病（GVHD）时出现了肠壁囊样积气（PCI）。由于存在大量腹腔游离气体且怀疑有腹膜炎，她接受了手术干预，但手术未发现肠穿孔或腹膜感染。通过鼻胃管抽吸、禁食及全身使用广谱抗生素，她在10天内从PCI中康复。BMT后出现伴有大量腹腔游离气体的PCI仅通过保守治疗应可控制。