PMID: 15218419Jun 26, 2004Paper

Surgery for acute graft-versus-host disease of the bowel: description of a pediatric case

Journal of Pediatric Hematology/oncology
Maura FaraciEdoardo Lanino

Abstract

Gastrointestinal acute graft-versus-host disease (GI-aGvHD) is still a common complication of allogeneic stem cell transplantation. Surgical management is an unusual approach, reserved for patients with intestinal occlusion, severe profuse rectal bleeding, or both. The authors describe a child with severe GI-aGvHD who did not respond to common immunosuppressive drugs and procedures and therefore underwent subtotal colectomy due to untreatable rectal bleeding. The bowel resection was followed by three "surgical looks" for occlusive intestinal episodes. In the end, a cholecystectomy for cholelithiasis was performed. The patient is still alive 41 months after stem cell transplantation, and although the terminal ileostomy is not closed yet, his quality of life is good. This experience suggests that surgery can be performed on children with severe, unresponsive GI-aGvHD.

References

May 1, 1988·American Journal of Surgery·G I McGregorG L Phillips
Dec 22, 1998·Diseases of the Colon and Rectum·J EvansM Schnitzler
Sep 12, 2000·Bone Marrow Transplantation·C PetersUNKNOWN International BFM Study Group--Subcommittee Bone Marrow Transplantation (IBFM-SG)
May 3, 2003·American Journal of Surgery·Andrew D JonesBrett C Sheppard

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Citations

Feb 14, 2012·Bone Marrow Transplantation·R F CornellW R Drobyski
Oct 30, 2012·International Surgery·Nandini C PalaniappaCelia M Divino
Mar 31, 2010·Leukemia & Lymphoma·Tyler L V GrayLillian Sung
Apr 24, 2010·Pediatric Transplantation·Adam GassasJohn Doyle
Feb 17, 2010·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·E CastagnolaC Viscoli

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