Noda M, Takeuchi Y, Tsujimoto T, Takimoto Y, Okita H
Department of Internal Medicine, National Otake Hospital.
Rinsho Ketsueki. 2001 Sep;42(9):696-700.
A 45-year-old man was diagnosed as having acute lymphocytic leukemia (ALL) in February 1997. Complete remission was achieved by chemotherapy, and allogeneic BMT from his HLA-identical sister was performed on November 13, 1997. He developed acute GVHD (grade II), but quickly recovered after methyl-PSL pulse therapy. On June 5, 1998--day 202 after BMT--abdominal pain developed. X-ray and CT examinations showed pneumatosis intestinalis, pneumoperitoneum, pneumomediastinum and abdominal free air. We performed oxygen administration and methyl-PSL pulse therapy, and this quickly improved the symptoms. Corticosteroid and chronic GVHD were thought to be the causative factors of pneumatosis intestinalis in this case. Although pneumatosis intestinalis is relatively rare, it is one of the important potential complications that can occur after allogeneic BMT.
一名45岁男性于1997年2月被诊断为急性淋巴细胞白血病(ALL)。通过化疗实现了完全缓解,并于1997年11月13日接受了来自其 HLA 匹配姐姐的异基因骨髓移植(BMT)。他发生了急性移植物抗宿主病(GVHD,II级),但在甲泼尼龙脉冲治疗后迅速恢复。1998年6月5日——BMT后第202天——出现腹痛。X线和CT检查显示肠壁积气、气腹、纵隔气肿和腹腔游离气体。我们进行了吸氧和甲泼尼龙脉冲治疗,症状迅速改善。在该病例中,皮质类固醇和慢性GVHD被认为是肠壁积气的致病因素。尽管肠壁积气相对罕见,但它是异基因BMT后可能发生的重要潜在并发症之一。