Pancreatitis necessitating urinary undiversion in a bladder-drained pancreas transplant.
After successful combined pancreaticoduodeno-renal transplant in an insulin-dependent diabetic, recurrent episodes of transplant pancreatitis were treated with Foley catheter drainage. The apparent cause of pancreatitis was increased pressure on the pancreatic duct due to infrequent voiding and a large bladder. A frequent voiding program partially relieved the pancreatitis, but final resolution necessitated conversion of the pancreaticoduodeno-cystostomy to a Roux-en-Y duodenojejunostomy at 6 months posttransplant. Both renal and pancreatic function are stable after 1 year, with no recurrence of pancreatitis since urinary undiversion. We believe pressure pancreatitis or urine reflux pancreatitis to be an infrequently reported cause of graft dysfunction in bladder-drained pancreas transplant recipients.
Department of Surgery, University of Texas Medical Branch, Galveston 77550.
J P
JP
Boudreaux
W H
WH
Nealon
R C
RC
Carson
J C
JC
Fish
D000208:Acute Disease; D000328:Adult; D000681:Amylases / Q000097:blood / Q000652:urine; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery*; D003928:Diabetic Nephropathies / Q000601:surgery; D004322:Drainage; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D016035:Pancreas Transplantation / Q000009:adverse effects*; D010195:Pancreatitis / Q000209:etiology* / Q000601:surgery; D001743:Urinary Bladder / Q000601:surgery*; D014547:Urinary Diversion
D000681:Amylases