Intensive
chemotherapy regimens can result in severe toxicities, particularly those that involve the digestive systems, leading to morbidity and mortality in this group of patients. Acute
enterocolitis can be a frequent complication. The authors performed a retrospective review or patients treated at their institution to ascertain the prognostic value of the clinical symptoms and signs of acute
enterocolitis, the corresponding abdominal ultrasonographic findings, and the impact of previous
chemotherapy. Amongst 1159 patients with
cancer treated at the Centro Infantil Boldrini from 2003 to 2007, 188 (16.2%) patients had 1 or more episode of
enterocolitis. An intestinal wall thickness of >or=3 mm on ultrasound was considered diagnostic of
enterocolitis. There were 231 episodes of
enterocolitis with a death rate of 11.7%. Previous
therapy with
cytarabine and the presence of abdominal distention affected survival. An intestinal wall thickness of >or=10 mm in the ultrasonographic examination was associated with greater mortality. In multivariate analysis, age, gender,
tumor type, degree of
neutropenia, intestinal wall thickness, and number of intestinal segments were not statistically significant difference. In children and young adults with
cancer and
enterocolitis, the clinical findings of 4 or more symptoms and presence of abdominal distention were associated with higher risk of death. Use of
cytarabine and an intestinal wall thickness of >or=10 mm were associated with a higher death rate.