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Updated: May 12, 2026
08:49
Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
Unexpected colonic perforation in a renal recipient: a case report
Kürşat Rahmi Serin1, Metin Keskin, Hüseyin Bakkaloğlu
1Department of General Surgery, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey. dr_krserin@yahoo.com.
Summary
Gastrointestinal perforation is a rare but serious complication following kidney transplants, often linked to immunosuppressant drugs. Prompt surgical intervention is crucial for patient survival and successful allograft function.
Area of Science:
- Transplantation Surgery
- Gastroenterology
- Immunosuppression Therapy
Background:
- Gastrointestinal complications, including bleeding and perforation, are recognized risks after solid organ transplantation.
- Immunosuppressant medications, essential for preventing allograft rejection, can increase the likelihood of these complications.
Observation:
- A 52-year-old male presented with wound drainage on postoperative day 7 after a living donor renal transplant.
- Despite no initial abdominal symptoms, computed tomography revealed diffuse extraluminal air, indicating a gastrointestinal perforation.
- Standard imaging and laboratory tests showed no signs of allograft dysfunction or other pathological findings.
Findings:
- Laparoscopic surgery converted to laparotomy identified a sigmoid colon perforation on the antimesenteric side.
- Causes such as diverticulitis, ischemia, or iatrogenic injury were ruled out.
- The patient underwent omentoplasty and sigmoid loop colostomy, with successful discharge and colostomy closure a year later.
Implications:
- Gastrointestinal complications, while potentially fatal, do not appear to adversely affect long-term renal allograft survival or function.
- High-dose immunosuppression in the early postoperative period or for rejection episodes is a common contributing factor.
- Early detection and aggressive management are vital for improving outcomes in transplant patients experiencing GI complications.
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