title: [Acute abdomen in renal transplant recipients. Epidemiology and treatment in not referral transplantation centers].
abstract: The incidence of gastrointestinal complications in renal transplant recipients is relatively high while about 10% is related to acute abdomen. Data concerning gastrointestinal (GI) complications were reported in literature mainly from referral center studies. A multicenter retrospectively survey was performed in Lazio, Italy, in order to evaluate the incidence of acute abdomen in renal transplant recipients observed to the emergency departments of not referral transplantation centers. Clinical and demographic findings regarding 14 patients who experienced acute abdomen between February 2005 and Dicember 2008 have been collected. The following data was investigated: etiology, diagnostic workup, duration of symptoms, elapsed time between admission and emergency operation if performed, morbility and mortality. The severity of disease at presentation was assessed by mean of the Acute Physiology and Chronic Health Evaluation score (APACHE II). Acute abdomen was due to pancreatitis in three patients (23.1%); to cholecystitis in three (23.1%); to acute diverticolitis with colon perforation in two patients (15.4%); to acute appendicitis in two (15.4%) and to intestinal obstruction in 2 patients (15.4%). Small bowel perforation was observed in two patients (15.4%) which one case, upon pathological examination, showed malignant lymphoma. The mean APACHE II score was 14.0 ± 5.9. Ten patients (71.4%) were submitted to surgery. Overall mortality and morbidity were 35% and 42% respectively. Statistical analysis showed admission APACHE II score (p<0.01), duration of symptoms (p<0.05), and total time elapsed between the onset of symptoms and treatment (p<0.04) as factors significantly related to mortality.
authors.affiliation: Sapienza Università di Roma.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Costa
authors.forename: S M
authors.initials: SM
authors.lastname: Tierno
authors.forename: F
authors.initials: F
authors.lastname: Stella
authors.forename: F
authors.initials: F
authors.lastname: Tomassini
authors.forename: L
authors.initials: L
authors.lastname: Venturini
authors.forename: B
authors.initials: B
authors.lastname: Frezza
authors.forename: L
authors.initials: L
authors.lastname: Fazzari
authors.forename: V
authors.initials: V
authors.lastname: Sinibaldi
authors.forename: C M
authors.initials: CM
authors.lastname: De Marco
authors.forename: G
authors.initials: G
authors.lastname: Cancrini
authors.forename: G
authors.initials: G
authors.lastname: Regine
mesh_terms: D018806:APACHE; D000006:Abdomen, Acute / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D000328:Adult; D000368:Aged; D005260:Female; D005767:Gastrointestinal Diseases / Q000150:complications; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D007558:Italy / Q000453:epidemiology; D016030:Kidney Transplantation / Q000009:adverse effects / Q000401:mortality; D008223:Lymphoma / Q000150:complications; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate