Contini Giorgia, Bertocchini Arianna, Carta Roberto, Merli Pietro, Inserra Alessandro, Bagolan Pietro, Morini Francesco
Medical and Surgical Department of the Fetus, Neonate and Infant, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Department of Pediatric Surgery, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Front Pediatr. 2021 Dec 8;9:700736. doi: 10.3389/fped.2021.700736. eCollection 2021.
A 2-year-old boy with severe combined immunodeficiency (SCID) developed intestinal graft-versus-host disease (GVHD) after hematopoietic stem cell transplantation (HSCT), associated with massive intestinal pneumatosis (IP), pneumoretroperitoneum (PRP), and pneumomediastinum. His fair clinical conditions allowed conservative management, with progressive normalization of imaging findings. The patient did not require surgery and is alive and in good clinical conditions at follow-up. In children with GVHD-related IP but good clinical conditions and no signs of peritonitis, IP is not a mandatory indication for surgery, despite its potentially striking imaging features. Conservative management, with intestinal rest, decompression, and antibiotics, often allows regression of the clinical picture.
一名患有严重联合免疫缺陷（SCID）的2岁男孩在造血干细胞移植（HSCT）后发生了肠道移植物抗宿主病（GVHD），伴有大量肠壁积气（IP）、腹膜后积气（PRP）和纵隔积气。他良好的临床状况允许进行保守治疗，影像学表现逐渐恢复正常。该患者无需手术，随访时存活且临床状况良好。对于患有与GVHD相关的IP但临床状况良好且无腹膜炎体征的儿童，尽管IP的影像学特征可能很显著，但它并非手术的强制指征。通过肠道休息、减压和使用抗生素进行保守治疗，通常可使临床表现消退。
