Conservative management of pneumatosis intestinalis after allogeneic hematopoietic SCT

摘要

Pneumatosis intestinalis (PI) is characterized by the accumulation of gas in the intestinal wall. It is not considered to be a disease itself, but rather a pathologic and radiographic finding. PI is associated with various disorders including chronic obstructive pulmonary disease, autoimmune disorders and solid organ transplantation. The radiographic imaging is diagnostic, showing air-filled bullae along the intestinal border and occasionally a pneumoperitoneum. PI has been observed and reported after allogeneic hematopoietic SCT (alloHSCT). The occurrence of PI in this setting is thought to be associated with chemotherapy, acute GVHD (aGVHD), immunosuppression and infections. As symptoms of PI may mimic gastrointestinal aGVHD (GI-aGVHD), PI is frequently diagnosed incidentally during imaging performed to evaluate GI-aGVHD. We describe a series of 16 patients presenting with PI after alloHSCT.