Assessment of abnormal bowel perfusion using contrast-enhanced ultrasonography after small bowel transplantation: a...

A 59-year-old man with short-bowel syndrome received a small bowel transplantation. Because the recipient complained of severe abdominal pain 40 hours after the surgery and was highly suspected of having mesenteric vascular thrombosis, contrast-enhanced sonography (CEUS) was performed at his bedside. CEUS demonstrated that the superior mesenteric artery was patent, but the bowel graft showed hypoenhancement, indicating severely inadequate perfusion of the graft. Due to this complication, the patient underwent an exploratory laporatomy, and the bowel graft was removed. The pathologic findings support the diagnosis of acute vascular rejection after intestinal transplantation. This case suggests that CEUS can be used to assess perfusion and vascular complications after intestinal transplantation, as it is noninvasive and easily performed at bedside.