Related Experiment Video
Updated: Aug 13, 2026
Small Bowel Transplantation In Mice
Published on: August 20, 2007
Anastomotic ulceration following small bowel transplantation
1Division of Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
Insights
Anastomotic ulcers (AU) are a newly identified complication after bowel transplantation. These ulcers can cause rectal bleeding and may recur, requiring careful monitoring in transplant patients.
Area of Science:
- Gastroenterology
- Transplantation Surgery
- Pediatric Surgery
Background:
- Bowel transplantation is a complex procedure with potential complications.
- Anastomotic ulcers (AU) have been reported after various surgeries but not previously after bowel transplantation.
Observation:
- Two pediatric patients developed recurrent rectal bleeding 6-9 months post-bowel transplant.
- Ulcers were found at the anastomosis sites (ileo-colonic and colo-colonic).
- Both patients had adenovirus in stool and were treated with rapamycin.
Findings:
- Histology showed granulation tissue and mild inflammation, ruling out rejection or infection.
- Literature review identified 29 AU cases from other surgical causes, none related to bowel transplant.
- Post-transplant factors may contribute to AU development.
Implications:
- Anastomotic ulcers are a potential multifactorial complication following bowel transplantation.
- Clinicians should consider AU in patients with anemia or rectal bleeding post-intestinal transplant.
- Awareness of this complication is crucial for timely diagnosis and management.
Abstract:
We describe, for the first time, anastomotic ulcers (AU) following bowel transplantation at the Hospital for Sick Children. Two children presented with rectal bleeding, 6 and 9 months, following the transplantation. Isolated ulcers were identified at the ileo-colonic and the colo-colonic anastomosis site. The ulcers resolved, but recurred 6 and 7 months after the initial presentation. Both patients were positive for adenovirus in the stool and were treated with rapamycin. The histology revealed granulation tissue formation with mild inflammation in the adjacent mucosa, without evidence of rejection or infection. A literature search revealed 10 studies reporting 29 patients who developed AU following various surgical etiologies, none of which was bowel transplant. Numerous factors that are unique to the post-transplant period may predispose to such ulcer and are discussed in detail. Physicians and surgeons should be aware of this multifactorial complication, among other etiologies, as a cause of anemia or rectal bleeding following intestinal transplantation.
Related Concept Videos
01:25Peptic Ulcer Disease V: Surgical Management and Nursing Care
Surgical Interventions for Peptic Ulcer Disease
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:26Aneurysm III: Interprofessional Care