Vincristine-induced megacolon

Rosenberg, Richard F.; Caridi, James G.

doi:10.1007/bf01948092

Cited by 16 publications

(8 citation statements)

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“…One retrospective study estimated that constipation occurred in 33% of patients receiving vincristine [16]. More significant side effects, such as anal fissure, paralytic ileus, pseudo-obstruction, and megacolon, have also been described, especially in cases involving vincristine overdose or liver failure or when vincristine is given concomitantly with azole-antifungals [17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Exploring the Attitudes of Pediatric Oncologists Toward the Use of Laxatives for the Prevention of Constipation in Patients Undergoing Active Treatment: A Canadian Perspective

Essa

Santo

Fleming

et al. 2013

Pediatric Hematology and Oncology

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Section: Introductionmentioning

confidence: 99%

Exploring the Attitudes of Pediatric Oncologists Toward the Use of Laxatives for the Prevention of Constipation in Patients Undergoing Active Treatment: A Canadian Perspective

Essa

Santo

Fleming

et al. 2013

Pediatric Hematology and Oncology

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“…Typhilitis, or inflammation of the cecum, is a necrotizing enterocolitis that occurs in neutropenic patients after chemotherapy. Chemotherapeutic agents as far ranging as vincristine and docetaxel have been implicated in the pathogenesis of megacolon [5, 6]. …”

Section: Introductionmentioning

confidence: 99%

Neostigmine for the treatment of acute colonic pseudo-obstruction (ACPO) in pediatric hematologic malignancies

et al. 2010

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BackgroundAcute colonic pseudo-obstruction (ACPO) refers to dilatation of the colon and decreased bowel motility without evidence of mechanical obstruction. Neostigmine, an acetylcholinesterase inhibitor, has been used in patients in whom supportive therapy failed to resolve ACPO. Here, we report the results of administering neostigmine to treat ACPO in children with hematologic malignancies.MethodsBetween September 2005 and December 2009, 10 patients (8 male and 2 female) were diagnosed with ACPO at the Department of Pediatrics, Catholic University of Korea. Diagnosis of ACPO was based on typical clinical features as well as colonic dilatation found on abdominal CT imaging. Neostigmine was administered subcutaneously at a dosage of 0.01 mg/kg/dose (maximum 0.5 mg) twice daily for a maximum of 5 total doses. ACPO was determined to be responsive to neostigmine if the patient showed both stool passage and improvement of clinical symptoms.ResultsThe study group included 8 acute lymphoblastic leukemia patients, 1 patient with malignant lymphoma, and 1 patient with juvenile myelomonocytic leukemia. The median age at ACPO diagnosis was 8.5 years (range, 3-14). Overall, 8 patients (80%) showed therapeutic response to neostigmine at a median of 29 hours after the initial administration (range, 1-70). Two patients (20%) showed side effects of grade 2 or above, but none complained of cardiovascular symptoms that required treatment.ConclusionIn this study, ACPO was diagnosed most often in late-childhood ALL patients. Subcutaneous neostigmine can be used to effectively treat ACPO diagnosed in children with hematologic malignancies without major cardiovascular complications.

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“…Hypoxic [25] and infectious lesions [26,27] seem to be of secondary importance in the development of atrophic hypoganglionosis. The effect of toxic drugs [28,29] could possibly aggravate the disturbed production of trophic factors. These mechanisms may explain the decrease in the number of nerve cells in the myenteric plexus.…”

Section: Discussionmentioning

confidence: 99%

Atrophic hypoganglionosis in the colon of adults with slow-transit constipation: a morphometric histopathological investigation

Stoss

Meier‐Ruge²,

Knecht³

et al. 2005

Eur Surg

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Zusammenfassung. Grundlagen: Die Kriterien einer Hypoganglionose in Kolonresektaten von Erwachsenen mit einer Slow-transit-Obstipation sind nicht genau definiert. Das Ziel der vorliegenden Untersuchung besteht in der Bestimmung der wichtigsten Parameter für die Diagnose einer Hypoganglionose an routinemäßig gewonnenen Transversalschnitten.Methodik: Zwölf histopathologisch diagnostizierte hypoganglionäre Hemikolektomie-Präparate des linken Kolon, die wegen einer Slow-transit-Obstipation reseziert worden waren, wurden mit 12 normalen HemikolektomiePräparaten ohne Obstipation verglichen, die wegen eines Vaginalprolaps, einer Pseudodivertikulose, einem Rektumprolaps etc. reseziert wurden. Alle Resektate wurden nativ caudocranial aufgerollt und in einem Kryostaten geschnitten. Es wurde ausschließlich mit nativem Gewebe gearbeitet. Der Plexus myentericus wurde mittels einer Azetylcholinesterase-Reaktion selektiv dargestellt. Nervenzellen wurden spezifisch mittels einer Nitroxidsynthase-und einer Laktatdehydrogenase-Reaktion gefärbt. An diesen Schnitten wurden morphometrische Messungen des Plexus myentericus mittels eines optisch-elektronischen Bildanalysegerätes durchgeführt. Die kontrastreiche Darstellung von Plexus myentericus und seinen Nervenzellen erlaubte Messungen der verschiedenen Strukturen mit einer semiautomatischen Grauwertdiskriminierung.Ergebnisse: Die atrophische Hypoganglionose des Plexus myentericus zeigte als eindrücklichsten Befund des linksseitigen Kolon eine signifikante Verminderung der Nervenzellzahl (-43,5 %). Die Flächen der Ganglienanschnitte des Plexus myentericus nahmen um 30,4 % ab. Die Anzahl der Ganglien verminderte sich um 19,7 %. Die Abstände der Ganglien nahmen nur tendenziell zu. Die Häufigkeit der Hypoganglionose des distalen Kolon von Erwachsenen lag in 759 Resektaten bei 33 %.Schlussfolgerungen: Die vorliegende Untersuchung zeigt, dass eine Hypoganglionose des Plexus myentericus mittels morphometrischer Technik zuverlässig objektiviert werden kann. Die Resultate demonstrieren, dass die atrophische Hypoganglionose durch eine signifikante Abnahme der Nervenzellen des Plexus myentericus charakterisiert ist. Die Ergebnisse unterstützen die Hypothese, dass einer Hypoganglionose des Erwachsenen am ehesten ein atrophischer Prozess zugrunde liegt und sie nicht wie bei Kindern eine primär hypoplastische Anomalie ist.Schlüsselwörter: Hypoganglionose, Kolon, Morphometrie, Plexus myentericus, Slow-transit-Obstipation.Summary. Background: The diagnostic criteria for hypoganglionosis in colon specimens from adults with chronic slow-transit constipation have not been defined properly. The aim of this study was to evaluate the most important diagnostic parameters for hypoganglionosis in routinely prepared transverse sections.Methods: Twelve histopathologically diagnosed hypoganglionic hemicolectomy specimens of the left colon, which had been resected due to chronic slow-transit constipation, were compared with 12 control hemicolectomy specimens which had been resected because of pseudodiverticulos...

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Vincristine-induced megacolon

Cited by 16 publications

References 3 publications

Exploring the Attitudes of Pediatric Oncologists Toward the Use of Laxatives for the Prevention of Constipation in Patients Undergoing Active Treatment: A Canadian Perspective

Exploring the Attitudes of Pediatric Oncologists Toward the Use of Laxatives for the Prevention of Constipation in Patients Undergoing Active Treatment: A Canadian Perspective

Neostigmine for the treatment of acute colonic pseudo-obstruction (ACPO) in pediatric hematologic malignancies

Atrophic hypoganglionosis in the colon of adults with slow-transit constipation: a morphometric histopathological investigation

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