title: Incidence, risk factors, and outcome of pneumatosis intestinalis in pediatric stem cell transplant recipients.
abstract: BACKGROUND
  Pneumatosis Intestinalis (PI) is a rare complication following hematopoietic stem cell transplant (HSCT). We sought to assess the incidence, risk factors, and outcome associated with PI.
  
  
  METHODS
  We retrospectively reviewed the incidence of PI among 178 patients who underwent allogeneic HSCT between September 1999 and February 2010.
  
  
  RESULTS
  Eighteen of 178 children (10.1%) who received allogeneic HSCT developed PI at a median of 94 days (range, 11-1169) after transplant. All patients presented with either abdominal pain or distention, and half of the patients had free air on radiographs. Patients who developed PI had a significantly higher proportion of acute (83% vs. 44%, P = 0.002) and chronic graft versus host disease (GVHD; 56% vs. 18%, P < 0.001). Only 39% of patients with PI had GVHD involving the gasterointestinal track. All patients were managed conservatively without surgery. Transplant related mortality (TRM) was significantly higher in patients who developed PI compared to those who did not (OR 4.3, 95% CI: 1.3-13.1; P = 0.007), but no deaths were attributable to PI.
  
  
  CONCLUSIONS
  We conclude that PI is a common complication associated with treatment of GVHD after HSCT, and patients who develop PI experience higher TRM. Patients who develop PI should be managed medically.
authors: Pediatric Stem Cell Transplant Program, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee, USA.
authors: Katrina
authors: K
authors: Korhonen
authors: Harold N
authors: HN
authors: Lovvorn
authors: Tatsuki
authors: T
authors: Koyama
authors: Elizabeth
authors: E
authors: Koehler
authors: Cassie
authors: C
authors: Calder
authors: Becky
authors: B
authors: Manes
authors: Misty
authors: M
authors: Evans
authors: Kathryn
authors: K
authors: Bruce
authors: Richard H
authors: RH
authors: Ho
authors: Jennifer
authors: J
authors: Domm
authors: Haydar
authors: H
authors: Frangoul
mesh_terms: D000208:Acute Disease; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D006086:Graft vs Host Disease / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D015994:Incidence; D008297:Male; D011006:Pneumatosis Cystoides Intestinalis / Q000209:etiology / Q000401:mortality / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D033581:Stem Cell Transplantation; D013997:Time Factors; D014184:Transplantation, Homologous