Early detection by ultrasound scan of severe post-chemotherapy gut complications in patients with acute leukemia

Background and Objective. Acute leukemia patients may develop life-threaten ing gut complications after intensive chemotherapy. We evaluated the role o f abdominal and pelvic ultrasound (US) examination in early detection of th ese complications. Design and Methods. A cohort of twenty adult acute leukemia patients underg oing intensive chemotherapy for remission induction entered the study. All chemotherapy regimens included cytarabine by continuous i.v. infusion for s everal days. Results. Three patients had severe gut complications: 2 cases of enterocoli tis and 1 case of gall bladder overdistension in the absence of calculi. In all cases the abnormality was documented by US examination: US scan showed thickening of the intestinal wall (two cases), and gall bladder overdisten sion with biliary sludge (one case). Immediate medical care included bowel rest, a broad-spectrum antibiotic, antimycotic treatment, and granulocyte c olony-stimulating factor. All patients recovered from the complication. Interpretation and Conclusions. We believe that the favorable outcome obtai ned hi our small series can be attributed to early diagnosis followed by ap propriate treatment. Early recognition by US and immediate medical manageme nt can lead to complete recovery of severe intestinal complications in pati ents with acute leukemia undergoing intensive chemotherapy. (C) 1999, Ferra ta Storti Foundation.