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Beyond gastrointestinal graft‐versus‐host disease. A lesson to learn
Author(s) -
Gassas Adam,
Zaidman Irina,
Schechter Tal,
Doyle John
Publication year - 2011
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/j.1399-3046.2010.01327.x
Subject(s) - medicine , host (biology) , graft versus host disease , disease , ecology , biology
Gassas A, Zaidman I, Schechter T, Doyle J. Beyond gastrointestinal graft‐versus‐host disease. A lesson to learn.
Pediatr Transplantation 2011: 15: E139–E141.
© 2010 John Wiley & Sons A/S. Abstract: The authors present a child with severe GvHD of GI tract with typical presentation of ileus and abdominal pain. However, the severe GvHD has led to multiple intermittent intussusceptions with resultant ischemic segments of the small bowel leading to sub‐acute mechanical intestinal obstruction. The clinical presentation of the mechanical intestinal obstruction was identical to the preceding ileus GvHD presentation. This has led to continuation of the conservative management with immunosuppressant therapy and delaying further investigation and surgical intervention. Once a barium study demonstrated the severe bowel constriction, laparoscopic surgical resection was necessary with excellent results. The resected small bowel showed multiple segments of ischemic ileitis leading to ulceration and severe stricture. The resection margins showed regenerating mucosa with no ulceration, but with focal evidence of mild GvHD.