Left labial edema after kidney transplantation

Abstract

Introduction: The differential diagnoses for labial edema are diverse. Labial edema after a kidney transplantation requires a thorough understanding of the various common and uncommon causes. Comprehensive history taking, physical examination, and awareness of anatomical knowledge will lead to proper diagnosis and treatment. Case Report: We present the case of an 18-year-old female with a past medical history of end stage renal disease secondary to bilateral atrophic kidneys and grade 3 vesicoureteral reflux status post deceased donor kidney transplant. She presented to the emergency department on postoperative day 5 due to uncontrolled hypertension and significant left labia minora edema with extreme pain to palpation. Gynecology evaluation and consultation determined the lesion was not suspicious for infection, abscess, or hematoma, and supportive care and conservative measures were initiated. Computed tomography (CT) was performed to rule out other causes of the anasarca, and after conservative management and doses of furosemide on hospital days 3 and 4, the patient showed improvement of the labial edema and blood pressure. Conclusion: A comprehensive differential diagnoses with reliance on anatomy and potential anomalies will lead clinicians and surgeons to properly treat potential postoperative complications. In this case, a thorough understanding of Mullerian anatomy and hemodynamic balance with implementation of conservative measures postoperatively resulted in resolution of the patient’s symptoms.