Intestinal perforation after combined liver-kidney transplantation for a case of congenital polycystic disease.

Abstract:

AIM:To highlight the intestinal perforation (IP), an uncommon and catastrophic complication after combined liver-kidney transplantation. METHODS:Combined liver-kidney transplantation (LKTx) with left kidney excision and a cyst fenestration procedure on the right kidney were performed on a case of 46-year-old female with congenital polycystic disease (CPCD). RESULTS:Two sites of IP were noted 40-50 cm proximal to ileocecal area during emergent laparotomy 10 d postoperatively. Despite aggressive surgical and medical management, disease progressed toward a fatal outcome due to sepsis and multiple organ failure 11 d later. CONCLUSION:Long duration of operation without venovenous bypass, overdose of steroid together with postoperative volume excess may all contribute to the risk of idiopathic multiple IPs. Microbiology and pathology inspections suggested that the infected cyst of the fenestrated kidney might be one reason for the fatal intra-peritoneal infection. Thus for the CPCD patients who seem to be very susceptible to infectious complications, any sign of suspected renal-infection found before or during LKTx is indication for the excision of original kidney. And the intensity of immunosuppression therapy should be controlled cautiously.

journal_name

World J Gastroenterol

authors

Peng T,Peng MH,Li LQ,Deng YL,Yang DH,Lu BY,Chen XG,Guo Y,Xiao KY,Chen B,Zhong Q,Wei MY

doi

10.3748/wjg.v10.i18.2769

keywords:

subject

Has Abstract

pub_date

2004-09-15 00:00:00

pages

2769-71

issue

18

eissn

1007-9327

issn

2219-2840

journal_volume

10

pub_type

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