INTRODUCTION: Acute diverticulitis with colon perforation is a serious condition in transplant recipients. The aim of this study was to analyze our experience with colon perforations among 875 renal transplant recipients between January 1986 and September 2004. METHODS: Patients were analyzed by age, gender, steroid dosage, time interval from the transplantation, delay between symptoms and surgery, clinical presentation, surgical procedure, graft and patient outcomes. RESULTS: We identified 8 patients with colon perforation. The incidence of perforation was 0.9%. Mean age at the the time of perforation was 58.5 years. Fever, abdominal pain, localized or diffuse signs of peritonitis, and leukocytosis were present in 7 patients (87.5%). Three patients (37.5%) were on steroid-free immunosuppression, whereas in 2 cases (25%) the steroid dosage was >20 mg/d. The mean interval between transplantation and perforation was 4.1 years. Two episodes (25%) occurred within 1 month following transplantation and the other 6 (75%) between 1 and 15 years. The interval between the onset of symptoms and surgery was longer than 48 hours in 1 patient (12.5%). In 5 cases (62.5%), a Hartmann procedure was performed; in 2 patients (25%), a resection with primary anastomosis was preferred. The last patient had a direct suture of the colon. Mortality rate was 12.5%. At a median follow-up of 6.1 years, 6 patients (75%) are alive with 5 functioning grafts. CONCLUSIONS: Colon perforations in renal transplant recipients remain a challenging surgical problem. An aggressive diagnostic attitude and an immediate surgical treatment may contribute to significantly decrease the incidence and the mortality of this complication.
INTRODUCTION: Acute diverticulitis with colon perforation is a serious condition in transplant recipients. The aim of this study was to analyze our experience with colon perforations among 875 renal transplant recipients between January 1986 and September 2004. METHODS:Patients were analyzed by age, gender, steroid dosage, time interval from the transplantation, delay between symptoms and surgery, clinical presentation, surgical procedure, graft and patient outcomes. RESULTS: We identified 8 patients with colon perforation. The incidence of perforation was 0.9%. Mean age at the the time of perforation was 58.5 years. Fever, abdominal pain, localized or diffuse signs of peritonitis, and leukocytosis were present in 7 patients (87.5%). Three patients (37.5%) were on steroid-free immunosuppression, whereas in 2 cases (25%) the steroid dosage was >20 mg/d. The mean interval between transplantation and perforation was 4.1 years. Two episodes (25%) occurred within 1 month following transplantation and the other 6 (75%) between 1 and 15 years. The interval between the onset of symptoms and surgery was longer than 48 hours in 1 patient (12.5%). In 5 cases (62.5%), a Hartmann procedure was performed; in 2 patients (25%), a resection with primary anastomosis was preferred. The last patient had a direct suture of the colon. Mortality rate was 12.5%. At a median follow-up of 6.1 years, 6 patients (75%) are alive with 5 functioning grafts. CONCLUSIONS: Colon perforations in renal transplant recipients remain a challenging surgical problem. An aggressive diagnostic attitude and an immediate surgical treatment may contribute to significantly decrease the incidence and the mortality of this complication.
Authors: Massimo Sartelli; Fausto Catena; Luca Ansaloni; Federico Coccolini; Ewen A Griffiths; Fikri M Abu-Zidan; Salomone Di Saverio; Jan Ulrych; Yoram Kluger; Ofir Ben-Ishay; Frederick A Moore; Rao R Ivatury; Raul Coimbra; Andrew B Peitzman; Ari Leppaniemi; Gustavo P Fraga; Ronald V Maier; Osvaldo Chiara; Jeffry Kashuk; Boris Sakakushev; Dieter G Weber; Rifat Latifi; Walter Biffl; Miklosh Bala; Aleksandar Karamarkovic; Kenji Inaba; Carlos A Ordonez; Andreas Hecker; Goran Augustin; Zaza Demetrashvili; Renato Bessa Melo; Sanjay Marwah; Sanoop K Zachariah; Vishal G Shelat; Michael McFarlane; Miran Rems; Carlos Augusto Gomes; Mario Paulo Faro; Gerson Alves Pereira Júnior; Ionut Negoi; Yunfeng Cui; Norio Sato; Andras Vereczkei; Giovanni Bellanova; Arianna Birindelli; Isidoro Di Carlo; Kenneth Y Kok; Mahir Gachabayov; Georgios Gkiokas; Konstantinos Bouliaris; Elif Çolak; Arda Isik; Daniel Rios-Cruz; Rodolfo Soto; Ernest E Moore Journal: World J Emerg Surg Date: 2016-07-29 Impact factor: 5.469
Authors: Ahmed Dirweesh; Afolarin Amodu; Muhammad Khan; Ritika Zijoo; Bushra Ambreen; Mohammad Ibrahim; Muhammad Ijaz; Abdelhameed Nawwar; Kareem Genena; Muhammad Tahir; Naresh Kumar; Vincent A Debari; Sara Wallach Journal: Gastroenterology Res Date: 2017-02-21
Authors: Sun-Young Chung; Seong Ho Park; Seung Soo Lee; Ju Hee Lee; Ah Young Kim; Su-Kil Park; Duck Jong Han; Hyun Kwon Ha Journal: Korean J Radiol Date: 2012-04-17 Impact factor: 3.500