Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 May 23;39(1):203.
doi: 10.1007/s00383-023-05485-z.

What is the role of neutropenia in pediatric cancer patients with pneumatosis intestinalis?

Shannon N Acker  1   2   3 , Sarah Ogle  4 , Emily H Cooper  5 , Alexander M Kaizer  5 , Ann M Kulungowski  4   6   5
Affiliations

What is the role of neutropenia in pediatric cancer patients with pneumatosis intestinalis?

Shannon N Acker et al. Pediatr Surg Int. .

Abstract

Background: We aimed to identify prognostic indicators in pneumatosis intestinalis (PI) in a pediatric oncology population. We hypothesized that neutropenia would be an independent risk factor for adverse outcomes, including the need for abdominal operation to treat PI and for the development of recurrent PI.

Methods: We performed a retrospective review of all patients treated for PI between 2009 and 2019 with a diagnosis of cancer or history of bone marrow transplant (BMT).

Results: Sixty-eight children were treated for their first episode of PI; 15 (22%) were not neutropenic at presentation; eight underwent urgent abdominal operation (12%). Patients with neutropenia were more likely to receive TPN, had a longer course of NPO, and received a longer course of antibiotics. Neutropenia at presentation was associated with a decreased risk of PI recurrence (40% vs 13%, p = 0.03). Children who required an abdominal operation were more likely to require vasopressors at diagnosis (50% vs 10%, p = 0.013).

Conclusions: Among pediatric cancer patients, need for vasopressors at the time of PI is a marker of severe PI, with increased likelihood of requiring operative intervention. The presence of neutropenia is associated with lower rates of PI recurrence.

Level of evidence: Level III.

Keywords: Neutropenia; Neutropenic enterocolitis; Pediatric cancer; Pneumatosis intestinalis.

PubMed Disclaimer

References

    1. Wu LL, Yang YS, Dou Y, Liu QS (2013) A systematic analysis of pneumatosis cystoids intestinalis. World J Gastroenterol 19(30):4973–4978. https://doi.org/10.3748/wjg.v19.i30.4973 - DOI - PubMed - PMC
    1. Rodrigues FG, Dasilva G, Wexner SD (2017) Neutropenic enterocolitis. World J Gastroenterol 23(1):42–47. https://doi.org/10.3748/wjg.v23.i1.42 - DOI - PubMed - PMC
    1. Ahsan N, Sun CC, Di John D (1988) Acute ileotyphlitis as presenting manifestation of acute myelogenous leukemia. Am J Clin Pathol 89(3):407–409. https://doi.org/10.1093/ajcp/89.3.407 - DOI - PubMed
    1. Alt B, Glass NR, Sollinger H (1985) Neutropenic enterocolitis in adults. Review of the literature and assessment of surgical intervention. Am J Surg 149(3):405–408. https://doi.org/10.1016/s0002-9610(85)80119-7 - DOI - PubMed
    1. Nesher L, Rolston KV (2013) Neutropenic enterocolitis, a growing concern in the era of widespread use of aggressive chemotherapy. Clin Infect Dis 56(5):711–717. https://doi.org/10.1093/cid/cis998 - DOI - PubMed

Substances

LinkOut - more resources