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首页> 美国卫生研究院文献>Annals of Saudi Medicine >Defecation of a colon cast as a rare presentation of acute graft-versus-host disease
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Defecation of a colon cast as a rare presentation of acute graft-versus-host disease

机译：排便冒号是急性移植物抗宿主病的罕见表现

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摘要

Diffuse involvement of the gastrointestinal tract by graft versus host disease (GVHD) is a common complication of allogeneic hematopoietic stem cell transplant (HSCT). Gastrointestinal GVHD usually presents 3 or more weeks after HSCT and is characterized by profuse diarrhea, anorexia, nausea, vomiting, abdominal pain and gastrointestinal bleeding. We report a case of a 23-year-old male who had undergone allogeneic HSCT and presented with bloody diarrhea on the 90th day post-HSCT. On the fourth day of admission, the patient passed per rectum a 27-cm long pinkish colored fleshy material recognized as a “colon cast”. Sigmoidoscopy showed a congested and erythematous rectum with the remaining portion of the “colon cast” attached to the proximal part of the sigmoid colon. A biopsy from the rectal wall was suggestive of grade IV GVHD. The patient was treated with methylprednisolone, cyclosporin and mycophenolate mofetil, with a partial response (diarrhea and abdominal pain improved), but then he developed multiple other medical complications and died after 3 months.
机译：异体造血干细胞移植（HSCT）的常见并发症是移植物与宿主疾病（GVHD）引起的胃肠道弥漫性累及。胃肠道GVHD通常在HSCT后3周或更长时间出现，其特征是大量腹泻，厌食，恶心，呕吐，腹痛和胃肠道出血。我们报告了一例23岁的男性，该男性曾接受过同种异体HSCT，并在HSCT后第90天出现血性腹泻。在入院的第四天，患者每个直肠通过了27厘米长的粉红色肉质物质，被认为是“冒号”。乙状结肠镜检查显示直肠充血和红斑，“冒号”的其余部分附着在乙状结肠的近端。直肠壁活检提示IV级GVHD。该患者接受甲基强的松龙，环孢菌素和霉酚酸酯的治疗，部分缓解（腹泻和腹痛得到改善），但随后出现了其他多种医学并发症，并在3个月后死亡。

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