MASSIVE INTESTINAL PNEUMATOSIS AND PNEUMORETROPERITONEUM FOLLOWING
HEMATOPOIETIC STEM CELL TRANSPLANTATION IN A 2-YEAR-OLD CHILD
Abstract
A 2-year-old boy with severe combined immunodeficiency developed gut
graft-versus-host disease (GVHD) after hematopoietic stem cell
transplantation (HSCT), associated with massive intestinal pneumatosis
(IP), pneumoretroperitoneum (PRP) and pneumomediastinum. His fair
clinical conditions allowed conservative management, with progressive
normalization of imaging findings. The patient did not require surgery
and is alive and in good clinical conditions at follow-up. In children
with GVHD-related IP but good clinical conditions and no signs of
peritonitis, IP, is not a mandatory indication for surgery, despite its
potentially striking imaging features. Conservative management, with
intestinal rest, decompression and antibiotics, often allows regression
of the clinical picture.