Perforated jejunal diverticulum in the use of mycophenolate mofetil

Area of Science:

• Gastroenterology
• Transplant Medicine
• Pharmacovigilance

Background:

• Jejunal diverticulosis is a rare condition with known complications like perforation.
• Gastrointestinal perforations are rare but documented adverse events associated with mycophenolate mofetil use.

Observation:

• A 44-year-old male with end-stage renal disease on mycophenolate mofetil presented with acute abdominal pain.
• Diagnosis was confirmed as a perforated jejunal diverticulum, treated with segmental resection and anastomosis.
• The patient experienced a recurrent jejunal perforation one month later, requiring a second surgery and discontinuation of mycophenolate mofetil.

Findings:

• This case report details a patient experiencing recurrent jejunal diverticulum perforation while on mycophenolate mofetil.
• The temporal association suggests a potential link between mycophenolate mofetil and jejunal perforation in susceptible individuals.

Implications:

• Highlights a rare but serious association between mycophenolate mofetil and jejunal diverticulum perforation.
• Emphasizes the need for increased clinical vigilance among physicians prescribing mycophenolate mofetil, especially in patients with risk factors for diverticular disease.
• Suggests considering alternative immunosuppressive strategies in patients with a history of gastrointestinal complications or those on mycophenolate mofetil presenting with abdominal pain.