Beware the band adhesion: an unexpected cause of double obstruction following intraperitoneal kidney transplantation

Author:

Tovmassian David1ORCID,Tang Linda1ORCID,Hameed Ahmer M1,Yao Jinna1,Yoon Peter Daechul1,Lee Taina1,Laurence Jerome M2,Yuen Lawrence P K1,Allen Richard D M1,Lau Howard1,Pleass Henry C C1

Affiliation:

1. Pancreas and Renal Transplant Unit, Westmead Hospital, Westmead, Australia

2. Liver and Renal Transplant Unit, Royal Prince Alfred Hospital, Camperdown, Australia

Abstract

Abstract Small bowel obstruction (SBO) following intraperitoneal renal transplantation, either solitary or due to simultaneous pancreas-kidney transplantation, is a known complication. While SBO is most commonly due to adhesions, there have been documented cases of internal herniation following simultaneous pancreas-kidney transplantation with enteric drainage due to the formation of a mesenteric defect. We present a unique complication in which the transplant ureter has caused strangulation and necrosis of a length of small intestine. The transplant ureter was mistaken for a band adhesion and divided. Post-operative anuria signalled this difficult diagnosis. Subsequent re-look laparotomy and ureteric reimplantation with Boari flap were required. Therefore, it is important to consider the ureter as a cause of internal herniation in kidney transplant patients and recognize that a band adhesion within the pelvis may in fact be the transplant ureter, obstructing a loop of small intestine beneath its course.

Publisher

Oxford University Press (OUP)

Subject

Surgery

Reference9 articles.

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