Pneumatosis intestinalis following cytotoxic or immunosuppressive treatment

Pneumatosis intestinalis (PI) is an uncommon condition characterized by the presence of gas within the bowel wall. We describe 5 cases of PI that occu rred after cytotoxic or immunosuppressive treatment for hematological disor ders. All patients were neutropenic shortly before or at the time of diagno sis of PI, but did not show specific symptoms. The diagnosis was made by co nventional X-ray and confirmed by abdominal computed tomography. Since ther e were no signs of secondary complications such as peritonitis, ischemia, o r perforation, conservative treatment with broad-spectrum antibiotics and p arenteral nutrition was initiated. All patients but 1 achieved complete res olution of PI after recovery from myelosuppression. Benign pneumoperitoneum due to PI should be considered in the differential diagnosis of free intra -abdominal air after chemotherapeutic or immunosuppressive therapy. It can be managed successfully by conservative treatment in the absence of seconda ry complications, if there is recovery of myelopoiesis. Copyright (C) 2001 S. Karger AG, Basel.