Skip to main content
NCBI home page
Postgraduate Medical Journal logoLink to Postgraduate Medical Journal
. 1994 Dec;70(830):921–923. doi: 10.1136/pgmj.70.830.921

Toxic megacolon complicating chemotherapy for acute myeloid leukaemia.

M A Wodziński 1, J A Snowden 1, J T Reilly 1
PMCID: PMC2398035  PMID: 7870642

Abstract

A 43 year old woman in remission from acute myeloid leukaemia developed abdominal pain, severe melaena, diarrhoea and gram-negative septicaemia whilst severely pancytopenic following consolidation chemotherapy. Subsequently, serial abdominal X-rays showed a progressive toxic megacolon. Conservative management was attempted but, because of radiological evidence of increasing colonic dilatation and incipient perforation, an emergency defunctioning colostomy was performed. The patient recovered and 2 months later the caecostomy was reversed and a right hemicolectomy performed. This first described case of toxic megacolon following leukaemia treatment is compared with three previously described cases following cytotoxic chemotherapy for other conditions.

Full text

PDF
921

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Atherton L. D., Leib E. S., Kaye M. D. Toxic megacolon associated with methotrexate therapy. Gastroenterology. 1984 Jun;86(6):1583–1588. [PubMed] [Google Scholar]
  2. Heppell J., Farkouh E., Dubé S., Péloquin A., Morgan S., Bernard D. Toxic megacolon. An analysis of 70 cases. Dis Colon Rectum. 1986 Dec;29(12):789–792. doi: 10.1007/BF02555345. [DOI] [PubMed] [Google Scholar]
  3. Hiruki T., Fernandes B., Ramsay J., Rother I. Acute typhlitis in an immunocompromised host. Report of an unusual case and review of the literature. Dig Dis Sci. 1992 Aug;37(8):1292–1296. doi: 10.1007/BF01296575. [DOI] [PubMed] [Google Scholar]
  4. Kunkel J. M., Rosenthal D. Management of the ileocecal syndrome. Neutropenic enterocolitis. Dis Colon Rectum. 1986 Mar;29(3):196–199. doi: 10.1007/BF02555024. [DOI] [PubMed] [Google Scholar]
  5. Martell R. W., Jacobs P. Surgery for the acute abdomen in adults with leukaemia. Postgrad Med J. 1986 Oct;62(732):915–918. doi: 10.1136/pgmj.62.732.915. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Pettit S., Irving M. H. ABC of colorectal diseases. Non-specific inflammatory bowel disease. BMJ. 1992 May 23;304(6838):1367–1371. doi: 10.1136/bmj.304.6838.1367. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Riedler L., Wohlgenannt D., Stoss F., Thaler W., Schmid K. W. Endoscopic decompression in "toxic megacolon". Surg Endosc. 1989;3(1):51–53. doi: 10.1007/BF00591317. [DOI] [PubMed] [Google Scholar]
  8. Shamberger R. C., Weinstein H. J., Delorey M. J., Levey R. H. The medical and surgical management of typhlitis in children with acute nonlymphocytic (myelogenous) leukemia. Cancer. 1986 Feb 1;57(3):603–609. doi: 10.1002/1097-0142(19860201)57:3<603::aid-cncr2820570335>3.0.co;2-k. [DOI] [PubMed] [Google Scholar]
  9. Snowden J. A., Young M. J., McKendrick M. W. Dilatation of the colon complicating acute self-limited colitis. Q J Med. 1994 Jan;87(1):55–62. [PubMed] [Google Scholar]
  10. Velanovich V., LaPorta A. J., Garrett W. L., Richards T. B., Cornett P. A. Pseudomembranous colitis leading to toxic megacolon associated with antineoplastic chemotherapy. Report of a case and review of the literature. Dis Colon Rectum. 1992 Apr;35(4):369–372. doi: 10.1007/BF02048116. [DOI] [PubMed] [Google Scholar]
  11. de Gara C. J., Gagic N., Arnold A., Seaton T. Toxic megacolon associated with anticancer chemotherapy. Can J Surg. 1991 Aug;34(4):339–341. [PubMed] [Google Scholar]

Articles from Postgraduate Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES