title: Unexpected colonic perforation in a renal recipient: a case report.
abstract: Gastrointestinal complications such as gastrointestinal bleeding and perforation due to immunosuppressant use are seen more frequently after solid organ transplantation. A 52-year-old male was admitted on the 7th day of a living donor renal transplantation with serous drainage at the incision site. He had no abdominal complaints. He was on triple immunosuppressant therapy. Abdominal plain X-ray and ultrasonography were normal, but diffuse extraluminal air was detected on the computed tomography scan. There were no pathological laboratory findings regarding the function of the renal allograft. We began the operation laparoscopically and then converted to laparotomy. Sigmoid colonic perforation was detected on the antimesenteric side. Neither diverticulitis nor ischemia was observed, and no evidence of iatrogenic injury was seen. There was no transrectal instrumentation history. Omentoplasty and sigmoid loop colostomy were performed. He was discharged on the 9th day following the operation. His colostomy was closed one year after the operation. Gastrointestinal complications can be fatal, but do not seem to influence the long-term survival or renal allograft function. Most of them are seen after using high doses of immunosuppressants to manage the early postoperative period or episodes of acute rejection. Early diagnosis and aggressive treatment play an important role in survival.
authors.affiliation: Department of General Surgery, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey. dr_krserin@yahoo.com.
authors.forename: Kürşat Rahmi
authors.initials: KR
authors.lastname: Serin
authors.forename: Metin
authors.initials: M
authors.lastname: Keskin
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Bakkaloğlu
authors.forename: Fatih
authors.initials: F
authors.lastname: Tunca
authors.forename: Ali Emin
authors.initials: AE
authors.lastname: Aydın
authors.forename: Cumhur Uluğ
authors.initials: CU
authors.lastname: Eldegez
mesh_terms: D003108:Colonic Diseases / Q000209:etiology*; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology