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Pneumatosis intestinalis after bone marrow transplantation
D L Day1, N K Ramsay, J G Letourneau
1Department of Radiology, University of Minnesota Hospitals, Minneapolis 55455.
AJR. American Journal of Roentgenology
|July 1, 1988
Summary
Pneumatosis intestinalis in bone marrow transplant patients, primarily affecting the colon, can have varied outcomes. Early detection and clinical correlation are crucial for managing this condition, which may be benign or fatal.
Area of Science:
- Gastroenterology
- Hematology
- Oncology
Background:
- Pneumatosis intestinalis is a rare finding in patients undergoing bone marrow transplantation.
- The clinical significance and prognostic implications of this condition in this specific patient population require further elucidation.
Purpose of the Study:
- To review the clinical and pathological data of bone marrow transplant recipients who developed pneumatosis intestinalis.
- To determine the significance of pneumatosis intestinalis in this patient cohort and identify associated factors and outcomes.
Main Methods:
- Retrospective review of clinical and pathological data from 18 bone marrow transplant patients with pneumatosis intestinalis.
- Analysis of patient demographics, symptoms, contributing factors, interventions, and outcomes.
Main Results:
- Pneumatosis intestinalis predominantly involved the colon (17/18 cases), especially the right side.
- Symptomatic patients (14) presented earlier than asymptomatic ones (4). Common symptoms included diarrhea, abdominal pain, and rectal bleeding.
- Contributing factors included chemotherapy, radiotherapy, steroids, infectious colitis, graft-versus-host disease, and septic shock. Intestinal disease led to death in 7 patients, required hemicolectomy in 1, and resolved conservatively in 10.
Conclusions:
- Bone marrow transplant recipients with pneumatosis intestinalis can experience diverse clinical courses, ranging from benign to fatal.
- The patient's underlying condition is a key determinant of the outcome.
- Clinical correlation is essential for accurately assessing the significance of pneumatosis intestinalis in this population.