人工肛門近傍グラフトに腸管狭窄を来し狭窄部腸管の部分切除を施行した脳死小腸移植術後長期生存症例

抄録

The patient was an 18-year-old woman complaining of persistent epigastralgia. She had undergone an isolated intestinal transplantation at the age of 12 for pseudo-Hirschsprung's disease. Endoscopy through the stoma revealed diffuse involvement of the distal part of the graft intestine, which had ulcerations associated with inflammation and edema, pathologically accompanied with signs of both rejection and viral infection. Though she was treated with bolus steroid for acute cellular rejection, a part of the ulceration did not improve, and the most distal part of the graft became stenotic. So she underwent partial resection of that part, and the symptoms improved. Partial resection of a graft stenosis part after a small bowel transplant can salvage a graft.