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Pneumatosis Intestinalis and Inferior Vena Caval Gas in a Patient with Neutropenic Enterocolitis

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The Medical Journal of Chosun University (조선대학교 의대논문집)
조선대학교 의학연구원 (Institute of Medical Science, Chosun University)
초록

Neutropenic enterocolitis (NE), the most serious gastrointestinal complication, has been reported as a clinical syndrome that occurs in the setting of disease- or chemotherapy-induced neutropenia. Complications of NE include bowel necrosis with perforation, fistula, stenosis, massive bleeding, abscess formation, and pneumatosis intestinalis (PI). Most physicians recommend initial conservative management with bowel rest, intravenous fluids, total parenteral nutrition, broad-spectrum antibiotics, and normalization of neutrophil counts. Surgical intervention is recommended in the event of obstruction, perforation, persistent gastrointestinal bleeding despite correction of thrombocytopenia and coagulopathy, or clinical deterioration. We experienced a patient whose abdominal computed tomography scan showed pneumoretroperitoneum, intramural gas in the colon, and inferior vena caval gas. Her condition improved after treatment with granulocyte colony-stimulating factor and broad-spectrum antibiotics. We report on this case along with a review of the literature.

저자
  • Jong Ho Yoon(Departments of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences)
  • Geon Wook Kang(Departments of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences)
  • Chae Ho Moon(Departments of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences)
  • Ha Ra Gu(Departments of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences)
  • Hong Seok Choi(Departments of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences)
  • Jung Mi Chang(Departments of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences)
  • Dong Yeop Shin(Departments of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences)
  • Sung Hyun Yang(Departments of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences)
  • Hye Jin Kang(Departments of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences) Corresponding Author
  • Byung Hee Lee(Departments of Internal Medicine and Radiology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences)