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Case Reports
. 2018 Jan;10(1):E42-E45.
doi: 10.21037/jtd.2017.11.121.

Pneumatosis intestinalis after lung transplantation for pulmonary graft-versus-host disease

Kumi Mesaki  1 , Seiichiro Sugimoto  1 , Shinji Otani  2 , Takeshi Kurosaki  2 , Kentaroh Miyoshi  1 , Masaomi Yamane  1 , Takahiro Oto  2
Affiliations
Case Reports

Pneumatosis intestinalis after lung transplantation for pulmonary graft-versus-host disease

Kumi Mesaki et al. J Thorac Dis. 2018 Jan.

Abstract

Pneumatosis intestinalis, which could complicate a spectrum of clinical conditions ranging from benign to life-threatening, is a rarely encountered complication after lung transplantation (LT). We describe two cases in which PI developed as a complication following LT for pulmonary graft-versus-host disease (GVHD) after hematopoietic stem cell transplantation (HSCT). In addition to the long-term immunosuppression administered for pulmonary GVHD, the intense immunosuppression needed after LT might increase the risk of PI in lung transplant recipients after HSCT. Conservative therapy should be considered for the treatment of PI developing after LT.

Keywords: Lung transplantation (LT); complications; computed tomography (CT); postoperative care.

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Conflict of interest statement

Conflicts of Interest: This work was presented at the 36th annual meeting and scientific sessions of the International Society for Heart and Lung Transplantation. April 2016; Washington, DC, USA.

Figures

Figure 1
Figure 1
Abdominal computed tomography at 4 months after lung transplantation showed free air under the diaphragm in case 1 (arrow) (A), and pneumatosis coli involving the ascending and transverse colon (B). Abdominal X-ray in the supine position showed pneumatosis involving the ascending colon (arrow) (C).
Figure 2
Figure 2
Abdominal computed tomography at 2 months after lung transplantation in case 2 revealed pneumatosis involving the colon (A,B), with a large amount of retroperitoneal air (arrow) (A).
Figure 3
Figure 3
Colonoscopy demonstrated multiple, flat-to-elevated submucosal lesions in case 2 (arrows) (A). Histological examination of biopsy specimens showed air within the submucosal area (arrows) (B), with no evidence of gastrointestinal graft-versus-host disease (hematoxylin & eosin staining).
See this image and copyright information in PMC

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