ULTRASOUND EXAMINATION OF BOWEL WALL THICKNESS IN PATIENTS WITH ACUTE INTESTINAL GRAFT-VERSUS-HOST DISEASE

Introduction. Haematopoietic stem cell transplantation is the treatment of choice in many patients with malignant diseases of the blood system. In such patients, acute graft-versus-host disease (GvHD) associated with intestinal damage constitutes one of the most serious complications. However, the volume of stool per day, which is currently used as the main diagnostic criterion for such conditions, does not always permit a timely diagnosis. Aim. To study the possibility of using intestine ultrasound examination for the diagnosis of acute intestinal GvHD. Materials and methods. The study included 50 patients having undergone transplantation of allogeneic haematopoietic stem cells, 40 of whom showed clinical signs of intestinal GvH D (diarrhoea> 500 ml/day). The control group included 10 patients who had undergone transplantation of allogeneic haematopoietic stem cells and exhibited no signs of gastrointestinal events. All patients underwent ultrasound measurement of intestinal wall thickness. Results. Patients were divided into three groups: those with acute GvHD, those with diarrhoea of viral or infectious origin, those with diarrhoea caused by the toxic effects of chemotherapy drugs. It is shown that the walls of all intestinal sections were significantly thicker in patients with acute GvHD as compared to the control group and patients with diarrhoea caused by other reasons. Conclusion. The thickening of the caecum wall (more than 3.25 mm) as detected using the ultrasound method can be used as a diagnostic sign of intestinal GvHD.