Presentation
Abdominal pain, history of bone marrow transplant.
Patient Data
Diffuse thickening and increased mucosal enhancement of the entire gastrointestinal tract - most notable in the small bowel, but also with some involvement of the stomach and colon as well. Small ascites. Feeding tube tip in the duodenal bulb. Some faint patchy areas of renal cortical hypoenhancement.
Case Discussion
The patient's history of bone marrow transplantation and the involvement of the entire gastrointestinal (GI) tract - stomach through to rectum - helps us to pause and consider systemic causes of GI tract inflammation. The major considerations with such diffuse involvement include vasculitis, eosinophilic gastroenteritis, and graft versus host disease (GvHD), with GvHD being the most likely cause and confirmed in this case.