PNEUMATOSIS-CYSTOIDES-INTESTINALIS WITH ABDOMINAL FREE-AIR IN A 2-YEAR-OLD GIRL AFTER ALLOGENEIC BONE-MARROW TRANSPLANTATION

A 2-year-old girl with acute lymphoblastic leukemia (ALL) showing a t( 4;11)(q22;q23) karyotype underwent allogeneic bone marrow transplantat ion (BMT) with the conditioning regimen of L-PAM (70 mg/m(2)/d for 3 d ays), busulfan (140 mg/m(2)/d for 2 days), and total body irradiation (12 Gy). On day 57, the patient developed pneumatosis cystoides intest inalis (PCI) when she received cyclosporin A and corticosteroids for g raft-versus-host disease (GVHD). Because of the presence of massive ab dominal free air and the suspicion of pertonitis, she underwent surgic al intervention, which, however, revealed neither intestinal perforati on nor peritoneal infection. She recovered from PCI in 10 days with na sogastric suction, fasting, and systemic broad-spectrum antibiotics. P CI with massive abdominal free air after BMT should be manageable by c onservative therapy alone.