Autodigestion of the glans penis and urethra by activated transplant pancreatic exocrine enzymes.
A case of synchronous kidney and pancreas transplantation in which a whole pancreas graft had been drained to the urinary bladder is discussed. On the 137th postoperative day, the patient presented with symptomatic balanitis and urethritis. Documented enzymatic activation of the trypsinogen/chymotrypsinogen, which is not present in symptom-free control patients, was thus thought to be responsible for these symptoms. Conversion to enteric drainage by means of a Roux-en-Y loop resulted in resolution of both symptoms and urinary enzymatic activation. Recurrent urinary tract infections were thought to be the most likely mechanism responsible for these findings.
Tom
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Munda
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First
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Alexander
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D000328:Adult; D001329:Autolysis / Q000209:etiology*; D001446:Balanitis / Q000209:etiology; D004789:Enzyme Activation; D006801:Humans; D008297:Male; D010179:Pancreas / Q000201:enzymology*; D016035:Pancreas Transplantation; D010413:Penis; D011183:Postoperative Complications; D014521:Urethra; D014526:Urethritis / Q000209:etiology