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KMID : 1141920200360040281
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Annals of Coloproctology
2020 Volume.36 No. 4 p.281 ~ p.284
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Small Bowel Perforation Associated With Gastrointestinal Graft-Versus-Host Disease and Cytomegalovirus Enteritis in a Patient With Leukemia: A Case Report With Literature Review
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Song Kwang-Seop
Kim Min-Jung
Lim Han-Ki
Hong Yoon-Hwa
Park Sung-Sil
Hong Chang-Won
Park Sung-Chan
Sohn Dae-Kyung
Han Kyung-Su
Oh Jae-Hwan
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Abstract
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Gastrointestinal graft-versus-host disease (GVHD) is a common complication after hematopoietic stem cell transplantation. Concomitant cytomegalovirus (CMV) enteritis worsens the prognosis of this condition. We report a case of small bowel perforation associated with gastrointestinal GVHD and CMV enteritis in a patient with leukemia who was successfully treated surgically. A 39-year-old man presented with intestinal perforation necessitating emergency surgical intervention. He was diagnosed with T-cell acute lymphoblastic leukemia and developed severe gastrointestinal GVHD and CMV enteritis after hematopoietic stem cell transplantation. His terminal ileum showed a perforation with diffuse wall thinning, and petechiae were observed over long segments of the distal ileum and the proximal colon. Small bowel segmental resection and a subtotal colectomy with a double-barreled ileocolostomy were performed. The patient recovered uneventfully after the operation. Based on reports described in the literature, surgery plays a minor role in the management of gastrointestinal GVHD; however, timely surgical intervention could be effective in selected patients.
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KEYWORD
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Graft vs host disease, Intestinal perforation, Surgical procedures
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