TOXIC MEGACOLON COMPLICATING CHEMOTHERAPY FOR ACUTE MYELOID-LEUKEMIA

A 43 year old woman in remission from acute myeloid leukaemia develope d abdominal pain, severe melaena, diarrhoea and gram-negative septicae mia whilst severely pancytopenic following consolidation chemotherapy. Subsequently, serial abdominal X-rays showed a progressive toxic mega colon. Conservative management was attempted but, because of radiologi cal evidence of increasing colonic dilatation and incipient perforatio n, an emergency defunctioning colostomy was performed. The patient rec overed and 2 months later the caecostomy was reversed and a right hemi colectomy performed. This first described case of toxic megacolon foll owing leukaemia treatment is compared with three previously described cases following cytotoxic chemotherapy for other conditions.