Pneumatosis intestinalis in patients after cadaveric kidney transplantation: possible relationship with an active cytomegalovirus infection.

Four patients are presented with pneumatosis intestinalis following kidney transplantation, all with severe cytomegalovirus (CMV) infection. Two patients had a primary infection and two patients had CMV reactivation. One patient died because of disseminated CMV infection. Two patients had concomitantly an active, non-obstructive duodenal ulcer. In a control population of 17 patients who suffered from a duodenal ulcer post-transplant without any evidence of CMV infection, we could not demonstrate pneumatosis intestinalis. We suggest a possible relationship between pneumatosis intestinalis and active CMV infection. The possible mechanisms responsible for this relationship are discussed.