ABSTRACT
OBJECTIVE: To acquire knowledge regarding the rare condition pneumatosis intestinalis (PI) in children treated for malignant disease. DESIGN: Retrospective. METHOD: In 1998-1999 PI was diagnosed in 9 of the 140 children with malignant disease in the department of Paediatric Oncology of the UMC St Radboud, Nijmegen, the Netherlands. By examination of the records of these 9 children, data were collected on the symptomatology, diagnostics, treatment and prognosis of PI. RESULTS: The 9 children included 7 boys and 2 girls, varying in age from 2 to 12 years. In 7 patients the underlying disease was acute lymphocytic leukaemia and in 2 it was a stage IV neuroblastoma. The presenting symptoms were nonspecific and included: a distended abdomen, abdominal pain, diarrhoea and constipation. In all children, PI was located in the colon. Supplemental blood and microbiological analysis did not reveal any typical abnormalities. 8 children were treated with lactitol because of constipation. A laparotomy was performed in the first patient, while the other 8 were treated with gastric suctioning, parenteral nutrition and antibiotics. All 9 children recovered within a few weeks. CONCLUSION: With supportive care, PI in children with malignant disease is mostly a self-limiting condition. A pneumoperitoneum in PI is no indication for surgery, except in the presence of an acute abdomen. Chemotherapy can be continued.
Subject(s)
Neuroblastoma/complications , Pneumatosis Cystoides Intestinalis/diagnosis , Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications , Antineoplastic Agents/therapeutic use , Child , Child, Preschool , Diagnosis, Differential , Female , Humans , Male , Neuroblastoma/drug therapy , Pneumatosis Cystoides Intestinalis/etiology , Pneumatosis Cystoides Intestinalis/pathology , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Prognosis , Retrospective StudiesABSTRACT
OBJECTIVE: To analyse the findings in adolescents between the ages of 12 and 17 who were admitted to the emergency ward as a result of excessive alcohol consumption. DESIGN: Retrospective. METHOD: The clinical characteristics, laboratory findings and treatment policy were studied in adolescents between the ages of 12 and 17 who were admitted for alcohol intoxication (> or = 1/1000) to the emergency wards of Leiden University Medical Centre, Juliana Children's Hospital, Haaglanden Medical Centre (Westeinde location) or the Leyenburg Hospital (all hospitals in the area of The Hague, The Netherlands) during the period 1999-2001. RESULTS: In the three successive years, the number of patients was 19, 18 and 51, respectively; there were a total of 58 boys and 30 girls. Laboratory determinations and other investigations were carried out and/or recorded in varying numbers of patients. The cause of the intoxication was usually the consumption of spirits together with friends; 60% of the patients had a Glasgow coma score < 15 and 30% were admitted to hospital. In 25% the visit to the emergency ward was preceded by an accident in which alcohol played a part. Little attention seems to have been paid to aftercare in the form of a follow-up visit.
