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Gastrointestinal complications following hematopoietic stem cell transplantation in children.

Lee JH, Lim GY, Im SA, Chung NG, Hahn ST - Korean J Radiol (2008 Sep-Oct)

Bottom Line: Gastrointestinal system involvement is one of the principal complications seen in the recipients of hematopoietic stem cell transplantation (HSCT), and it is also a major cause of morbidity and death in these patients.The major gastrointestinal complications include typhlitis (neutropenic enterocolitis), pseudomembranous enterocolitis, viral enteritis, graft-versus-host disease, benign pneumatosis intestinalis, intestinal thrombotic microangiopathy, and post-transplantation lymphoproliferative disease.As these patients present with nonspecific abdominal symptoms, evaluation with using such imaging modalities as ultrasonography and CT is essential in order to assess the extent of gastrointestinal involvement and to diagnose these complications.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.

ABSTRACT
Gastrointestinal system involvement is one of the principal complications seen in the recipients of hematopoietic stem cell transplantation (HSCT), and it is also a major cause of morbidity and death in these patients. The major gastrointestinal complications include typhlitis (neutropenic enterocolitis), pseudomembranous enterocolitis, viral enteritis, graft-versus-host disease, benign pneumatosis intestinalis, intestinal thrombotic microangiopathy, and post-transplantation lymphoproliferative disease. As these patients present with nonspecific abdominal symptoms, evaluation with using such imaging modalities as ultrasonography and CT is essential in order to assess the extent of gastrointestinal involvement and to diagnose these complications. We present here a pictorial review of the imaging features and other factors involved in the diagnosis of these gastrointestinal complications in pediatric HSCT recipients.

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Related in: MedlinePlus

Pseudomembranous colitis in 9-year-old boy, and this developed on 23rd day after bench mark test for treating his leukemia.A. Longitudinal US of ascending colon shows rather striking diffuse thickening of colonic wall (arrows). Exaggerated haustral markings and inhomogenously thickened submucosa with apposition of muscosal surfaces of thickened wall are noted.B, C. Axial contrast enhanced CT shows pancolitis involving ascending, transverse, descending (B) and rectosigmoid colon (C). Note the hyperemic enhancing mucosa surrounded by thickened hypodense submucosa edema, which forms accordion pattern (arrows).
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Figure 2: Pseudomembranous colitis in 9-year-old boy, and this developed on 23rd day after bench mark test for treating his leukemia.A. Longitudinal US of ascending colon shows rather striking diffuse thickening of colonic wall (arrows). Exaggerated haustral markings and inhomogenously thickened submucosa with apposition of muscosal surfaces of thickened wall are noted.B, C. Axial contrast enhanced CT shows pancolitis involving ascending, transverse, descending (B) and rectosigmoid colon (C). Note the hyperemic enhancing mucosa surrounded by thickened hypodense submucosa edema, which forms accordion pattern (arrows).

Mentions: The US features of PMC include exaggerated and inhomogenously thickened submucosa with apposition of the mucosal surfaces of the thickened wall (Fig. 2A). The characteristic CT feature of PMC is diffuse colonic wall thickening with low attenuation and trapped contrast media between the thickened haustral folds, and this is referred to as the "accordion sign" (Figs. 2B, C). Pancolonic involvement is common in patients with PMC, but this involvement may be focal or restricted to the right or rectosigmoid colon.


Gastrointestinal complications following hematopoietic stem cell transplantation in children.

Lee JH, Lim GY, Im SA, Chung NG, Hahn ST - Korean J Radiol (2008 Sep-Oct)

Pseudomembranous colitis in 9-year-old boy, and this developed on 23rd day after bench mark test for treating his leukemia.A. Longitudinal US of ascending colon shows rather striking diffuse thickening of colonic wall (arrows). Exaggerated haustral markings and inhomogenously thickened submucosa with apposition of muscosal surfaces of thickened wall are noted.B, C. Axial contrast enhanced CT shows pancolitis involving ascending, transverse, descending (B) and rectosigmoid colon (C). Note the hyperemic enhancing mucosa surrounded by thickened hypodense submucosa edema, which forms accordion pattern (arrows).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2627203&req=5

Figure 2: Pseudomembranous colitis in 9-year-old boy, and this developed on 23rd day after bench mark test for treating his leukemia.A. Longitudinal US of ascending colon shows rather striking diffuse thickening of colonic wall (arrows). Exaggerated haustral markings and inhomogenously thickened submucosa with apposition of muscosal surfaces of thickened wall are noted.B, C. Axial contrast enhanced CT shows pancolitis involving ascending, transverse, descending (B) and rectosigmoid colon (C). Note the hyperemic enhancing mucosa surrounded by thickened hypodense submucosa edema, which forms accordion pattern (arrows).
Mentions: The US features of PMC include exaggerated and inhomogenously thickened submucosa with apposition of the mucosal surfaces of the thickened wall (Fig. 2A). The characteristic CT feature of PMC is diffuse colonic wall thickening with low attenuation and trapped contrast media between the thickened haustral folds, and this is referred to as the "accordion sign" (Figs. 2B, C). Pancolonic involvement is common in patients with PMC, but this involvement may be focal or restricted to the right or rectosigmoid colon.

Bottom Line: Gastrointestinal system involvement is one of the principal complications seen in the recipients of hematopoietic stem cell transplantation (HSCT), and it is also a major cause of morbidity and death in these patients.The major gastrointestinal complications include typhlitis (neutropenic enterocolitis), pseudomembranous enterocolitis, viral enteritis, graft-versus-host disease, benign pneumatosis intestinalis, intestinal thrombotic microangiopathy, and post-transplantation lymphoproliferative disease.As these patients present with nonspecific abdominal symptoms, evaluation with using such imaging modalities as ultrasonography and CT is essential in order to assess the extent of gastrointestinal involvement and to diagnose these complications.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.

ABSTRACT
Gastrointestinal system involvement is one of the principal complications seen in the recipients of hematopoietic stem cell transplantation (HSCT), and it is also a major cause of morbidity and death in these patients. The major gastrointestinal complications include typhlitis (neutropenic enterocolitis), pseudomembranous enterocolitis, viral enteritis, graft-versus-host disease, benign pneumatosis intestinalis, intestinal thrombotic microangiopathy, and post-transplantation lymphoproliferative disease. As these patients present with nonspecific abdominal symptoms, evaluation with using such imaging modalities as ultrasonography and CT is essential in order to assess the extent of gastrointestinal involvement and to diagnose these complications. We present here a pictorial review of the imaging features and other factors involved in the diagnosis of these gastrointestinal complications in pediatric HSCT recipients.

Show MeSH
Related in: MedlinePlus