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Case Reports
. 2010 Oct 21:2010:bcr0520103033.
doi: 10.1136/bcr.05.2010.3033.

Graft-versus-host disease

Joel A Newman  1 , Sophie Candfield, David Howlett, Paula McKenzie, Satyajit Sahu
Affiliations
Case Reports

Graft-versus-host disease

Joel A Newman et al. BMJ Case Rep. .

Abstract

This article presents the case of a 26-year-old man who was diagnosed with pneumatosis cystoides intestinalis, a rare consequence of colonic graft-versus-host disease, after CT imaging revealed free air tracking within the bowel wall and abdomen. His presentation with hiccups, abdominal and neck distension, along with diarrhoea was also unusual, and this case highlights the need for a high index of suspicion when treating post stem cell transplant patients.

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Conflict of interest statement

Competing interests None.

Figures

Figure 1
Figure 1
Axial CT imaging of the lower abdomen demonstrates changes with pneumatosis cystoides intestinalis, with air seen in the caecal wall (arrows). Some free intraperitoneal air is also present (arrowheads).
Figure 2
Figure 2
Axial CT imaging of the root of the neck shows extensive surgical emphysema with air tracking between muscle planes anteriorly and posteriorly.
See this image and copyright information in PMC

References

    1. Zülke C, Ulbrich S, Graeb C, et al. Acute pneumatosis cystoides intestinalis following allogeneic transplantation – the surgeon's dilemma. Bone Marrow Transplant 2002;29:795–8 - PubMed
    1. Braumann C, Menenakos C, Jacobi CA. Pneumatosis intestinalis–a pitfall for surgeons? Scand J Surg 2005;94:47–50 - PubMed
    1. Day DL, Ramsay NK, Letourneau JG. Pneumatosis intestinalis after bone marrow transplantation. AJR Am J Roentgenol 1988;151:85–7 - PubMed

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