Acute lymphoblastic leukemia with pneumatosis cystoides intestinalis after hematopoietic stem cell transplantation: a case report

Abstract

Pneumatosis cystoides intestinalis (PCI) is a rare condition characterized by air accumulation within the subserosa or submucosa of the gastrointestinal wall. We herein report a case involving a woman in her early 30s who developed PCI after undergoing allogeneic hematopoietic stem cell transplantation (HSCT) for acute lymphoblastic leukemia. The patient had a history of multiple COVID-19 infections. Imaging revealed extensive pneumoperitoneum and mesenteric emphysema; nevertheless, the patient remained clinically stable with a benign abdominal examination. She eventually recovered after 1 month of conservative treatment. We believe the PCI in this case had a multifactorial etiology, potentially involving both HSCT and COVID-19. Raising awareness of PCI may help avoid unnecessary surgical interventions and associated morbidity.

Keywords: COVID-19; Pneumatosis cystoides intestinalis; acute lymphoblastic leukemia; graft-versus-host disease; immunosuppression; treatment.

Figure 1.

Computed tomography angiography scan at admission. The red arrows show scattered gas accumulation around the colorectal wall and retroperitoneum.

Figure 2.

Computed tomography scan showing less scattered gas compared with the previous results.