Reactions 910 - 13 Jul 2002

Antineoplastics/corticosteroids

Pneumatosis cystoides intestinalis: case reportA 46-year-old woman developed acute pneumatosis

cystoides intestinalis after receiving antineoplastic therapy forbreast cancer and long-term corticosteroid therapy for chronicgraft versus host disease (GVHD).

The woman, who had undergone allogeneic bone marrowtransplantation 1 year previously and subsequently developedchronic GVHD with associated gastrointestinal disturbance,presented with lower abdominal pain approximately 10months after last receiving antineoplastic therapy. She hadbeen diagnosed with breast cancer 4 years earlier and hadbeen treated with various antineoplastic regimes over the next3 years. At the time of presentation her medication includedlong-term corticosteroid therapy for GVHD andmycophenolate mofetil. Upon examination she was found tobe in poor general condition with a distended, tense abdomenand lacking normal bowel movements. An abdominal x-raydemonstrated massive pericolic gas accumulation around theascending and transverse colon. A CT scan supported adiagnosis of a locally contained perforation of the colon withpneumatosis coli.

A laparotomy was carried out and the woman wasdiagnosed with pneumatosis cystoides intestinalis, mainly ofthe right and transverse colon and attached mesentery. Shereceived broad spectrum antibacterials, her corticosteroiddosage was increased and she was discharged 9 days laterwith no further gastrointestinal problems. Regular follow-upduring the following year did not reveal any signs ofpneumatosis cystoides intestinalis recurrence.Zulke C, et al. Acute pneumatosis cystoides intestinalis following allogeneictransplantation - the surgeon’s dilemma. Bone Marrow Transplantation 29:795-798, No. 9, May 2002 - Germany 800911251

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Reactions 13 Jul 2002 No. 9100114-9954/10/0910-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved