Eur J Pediatr Surg 2010; 20(6): 426-429
DOI: 10.1055/s-0030-1254148
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© Georg Thieme Verlag KG Stuttgart · New York

Nonoperative Management of Pneumatosis Intestinalis and Pneumoperitoneum in a Patient with Acute Lymphoblastic Leukemia: Case Report and Review of the Literature

J. A. Naiditch1 , R. Duerst2 , S. Pillai3 , A. Chin4
  • 1Northwestern University, Department of Surgery, Chicago, United States
  • 2Children's Memorial Hospital, Division of Hematology, Oncology, Transplantation,Chicago, United States
  • 3University at Illinois Chicago, Division of Pediatric Surgery, Chicago, United States
  • 4Children's Memorial Hospital, Division of Pediatric Surgery, Chicago, United States
Further Information

Publication History

Publication Date:
09 July 2010 (online)


Pneumoperitoneum (PP) in the absence of intra-abdominal catastrophe is a rare entity described in non-neonatal children with leukemia [1] [2] [3] [4] [5] [6] [7] [8] [9], immune deficiency diseases, hematological disorders [1] [6] [10], or other chronic disease processes [6]. The free air is theorized to be produced by ruptured pneumatoceles present in pneumatosis intestinalis (PI). The nonoperative management of patients with pneumoperitoneum, although previously described in the references cited above as successful in selected cases, is controversial in the literature and debatable in clinical practice. We present a case report of a child with acute lymphoblastic leukemia who presented with pneumatosis intestinalis and pneumoperitoneum and was managed nonoperatively. We reviewed the literature with the aim of delineating the circumstances under which children with these findings may be conservatively managed with a period of close observation, perhaps avoiding the morbidity associated with surgery.


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Dr. Anthony Chin

Children's Memorial Hospital

Division of Pediatric Surgery


United States

Phone: +01 773 880 4340

Fax: + 01 773 880 4588