Perforated jejunitis in a child with acute lymphoblastic leukemia treated with pegaspargase

Survival rates of children with acute lymphoblastic leukemia have improved since the incorporation of asparaginase in the treatment protocol, but the medication has potential serious complications, including vascular thrombosis. Here, we describe the case of a 13-year-old boy with pre-T-cell acute l...

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Bibliographic Details
Published inRadiology case reports Vol. 13; no. 3; pp. 568 - 572
Main Authors Tang, Elizabeth R, Chapman, Teresa, Finn, Laura S, Leger, Kasey J
Format Journal Article
LanguageEnglish
Published Netherlands Elsevier 01.06.2018
Subjects
Pediatric
Acute lymphoblastic leukemia
Computed tomography
Complications
Acute mesenteric ischemia
Pediatric
Asparaginase
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Summary:Survival rates of children with acute lymphoblastic leukemia have improved since the incorporation of asparaginase in the treatment protocol, but the medication has potential serious complications, including vascular thrombosis. Here, we describe the case of a 13-year-old boy with pre-T-cell acute lymphoblastic leukemia whose treatment course was complicated by perforated jejunitis requiring resection of a portion of his small bowel. Pathologic assessment showed transmural ischemia, mesenteric venous and arterial thrombi, and scattered cytomegalovirus inclusion bodies. Pediatric mesenteric ischemia is rare, and its consideration in patients treated with asparaginase is discussed.
ISSN:1930-0433
1930-0433
DOI:10.1016/j.radcr.2018.02.017