Surgery for intestinal graft-versus-host disease - Report of two cases

PURPOSE: With allogeneic bone marrow transplantation becoming increasingly common, intestinal graft-versus-host disease often is seen within specializ ed transplant units. Surgeons are involved infrequently in the management o f such patients, and yet occasionally are called upon to operate on critica lly ill patients with refractory disease. This article reviews the salient features of this condition and discusses possible indications for surgery. METHOD: Two cases of intestinal graft-versus-host disease that required lap arotomy are presented. RESULTS: A 24-year-old male with severe, unremitting , acute intestinal graft-versus-host disease underwent small-bowel and larg e-bowel resections for massive bleeding. A 35-pear-old male with recurrent symptoms of small-bowel obstruction after allogeneic bone marrow transplant ation underwent small-bowel resection and multiple strictureplasties for ch ronic intestinal graft-versus-host disease. CONCLUSION: Surgery can be per formed for complications of intestinal graft-versus-host disease not respon ding to medical therapy, with successful outcome.