Successful Non-Operative Management of Extensive Pneumatosis Cystoides Intestinalis Due to Graft Versus Host Disease.
Christine A CastaterLouise A GligaCourtney H MeyerBen HazenWendy GreeneBabar FizaPublished in: The American surgeon (2022)
Graft versus host disease is a serious complication of allogenic stem cell transplants and can manifest with gastrointestinal complications including pneumatosis cystoides intestinali (PCI). A 43-year-old male with a history of acute myeloid leukemia presented to the hospital with abdominal pain and sepsis. The patient was intubated and admitted to the ICU. His CT scan demonstrated extensive colonic pneumatosis. He was high risk for laparotomy so was treated non-operatively. He improved and his abdominal exam remained benign. With aggressive resuscitation, close monitoring, and antibiotics, the patient was able to avoid major abdominal surgery. pneumatosis cystoides intestinali is a concerning finding that often leads to surgical interventions. Concurrent sepsis, gut ischemia, and frank perforation often lead to surgical intervention. In patients with high surgical risk and lack of critical bowel findings, non-operative management can be successful.
Keyphrases
- intensive care unit
- stem cells
- acute myeloid leukemia
- septic shock
- abdominal pain
- case report
- computed tomography
- acute kidney injury
- randomized controlled trial
- cardiac arrest
- coronary artery disease
- acute myocardial infarction
- acute coronary syndrome
- squamous cell carcinoma
- magnetic resonance imaging
- physical activity
- percutaneous coronary intervention
- emergency department
- dual energy
- allogeneic hematopoietic stem cell transplantation
- magnetic resonance
- heart failure
- antiplatelet therapy
- st segment elevation myocardial infarction
- radiation therapy
- acute lymphoblastic leukemia
- cell therapy
- st elevation myocardial infarction
- atrial fibrillation
- adverse drug
- locally advanced
- ulcerative colitis
- coronary artery bypass