Transplant with a twist: A pitfall in sonographic diagnosis of renal transplant torsion.
Torsion is an uncommon cause of impaired function in a renal transplant. We present a case of intraperitoneal transplant torsion secondary to adhesions to the left fallopian tube and ovary. Inability to confirm renal venous flow with Doppler misled to the erroneous sonographic diagnosis of renal vein thrombosis, although end diastolic flow was absent rather than reversed. The correct diagnosis was made with CT. The combination of abnormal orientation of the graft on ultrasonography, acutely impaired renal function, and abnormal Doppler study should have led to a diagnosis of transplant torsion. The case is also unusual in that the lead point was adnexal pathology. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:528-530, 2017.
Swedish Medical Center, General Surgery Residency, Seattle, WA.
Evan
E
Narasimhan
Department of Radiology and Imaging Sciences, University of Utah Medical Center, Salt Lake City, UT.
Anne
A
Kennedy
Transplant Surgery Division, Department of Surgery, University of Utah Medical Center, Salt Lake City, UT.
Jeffrey
J
Campsen
D000328:Adult; D003937:Diagnosis, Differential; D005187:Fallopian Tubes / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000601:surgery; D007674:Kidney Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D016030:Kidney Transplantation; D010048:Ovarian Cysts / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D010053:Ovary / Q000000981:diagnostic imaging / Q000601:surgery; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods; D014102:Torsion Abnormality / Q000000981:diagnostic imaging*; D018615:Ultrasonography, Doppler, Color / Q000379:methods*
Doppler; pitfall; renal transplant; torsion; ultrasonography