Refractory hematuria in an oliguric patient after pancreas transplantation with exocrine pancreas bladder drainage.
A 52-yr-old man presented with hematuria and clot retention. He had undergone simultaneous pancreas-kidney transplantation with exocrine pancreas bladder drainage 16 yr ago. The patient suffered from progressive transplant kidney failure with gradually decreasing urine output and needed hemodialysis every other day. Gross hematuria persisted after removal of all blood clots. Cystoscopy showed multiple small, flat ulcers of the bladder mucosa. Some bled discretely and were coagulated cautiously. However, hematuria was refractory to multiple urological interventions, which eventually necessitated an enteric diversion of the exocrine pancreas. Hematuria ceased following an uneventful postoperative course.
Kiss
Bernhard
B
Department of Urology, University of Bern, Bern, Switzerland.
Birkhäuser
Frédéric D
FD
Fleischmann
Achim
A
Candinas
Daniel
D
Studer
Urs E
UE
Kessler
Thomas M
TM
D003558:Cystoscopy; D004322:Drainage; D006417:Hematuria / Q000209:etiology / Q000601:surgery*; D015312:Hemodialysis Solutions; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D009846:Oliguria / Q000209:etiology / Q000601:surgery*; D016035:Pancreas Transplantation / Q000009:adverse effects* / Q000379:methods; D046790:Pancreas, Exocrine / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D051437:Renal Insufficiency / Q000209:etiology / Q000473:pathology / Q000628:therapy; D013927:Thrombosis / Q000473:pathology / Q000601:surgery; D014456:Ulcer / Q000473:pathology; D001743:Urinary Bladder / Q000473:pathology
D015312:Hemodialysis Solutions