Hepatic portal venous gas associated with severe graft-versus-host disease of the gastrointestinal tract

Intern Med. 2012;51(17):2417-21. doi: 10.2169/internalmedicine.51.7419. Epub 2012 Sep 1.

Abstract

We report a 67-year-old woman who was diagnosed with hepatic portal venous gas associated with severe graft-versus-host disease (GVHD) of the gastrointestinal tract. The patient received allogenic peripheral blood stem cell transplantation from a haploidentical son against Philadelphia chromosome-positive acute lymphocytic leukemia. The patient developed grade 3 intestinal GVHD on day 90 from the transplantation. On day 149, she presented septic shock and computed tomography (CT) scan revealed hepatic portal venous gas (HPVG); an ileocecal resection was performed immediately. The damage of gastrointestinal mucosa by GVHD resulted in the invasion of gas-producing bacteria. Although HPVG-associated gastrointestinal GVHD is extremely rare, we should pay special attention to this pathogenesis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Apoptosis
  • Cecum / pathology
  • Cecum / surgery
  • Fatal Outcome
  • Female
  • Gases / metabolism*
  • Gastrointestinal Diseases / etiology
  • Gastrointestinal Diseases / immunology
  • Gastrointestinal Diseases / metabolism*
  • Gastrointestinal Tract / immunology
  • Gastrointestinal Tract / metabolism*
  • Gastrointestinal Tract / microbiology
  • Graft vs Host Disease / etiology
  • Graft vs Host Disease / immunology
  • Graft vs Host Disease / metabolism*
  • Humans
  • Ileum / pathology
  • Ileum / surgery
  • Peripheral Blood Stem Cell Transplantation / adverse effects
  • Portal Vein / metabolism*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / surgery
  • Severity of Illness Index*

Substances

  • Gases