Bleeding from cecal ulcers in renal transplant patients.

Cecal ulcerations represent a high percentage of causes of gastrointestinal bleeding in renal transplant patients. A close association of these lesions with cytomegalovirus (CMV) infection has been found, even though a cause-effect relationship has not been established. All of these patients are usually critically ill, and a progressive deterioration leading to death is the rule. Our experience suggests that the decrease of immunosuppressive drug therapy, followed by the nephrectomy of the transplanted kidney if signs of rejection are present, and right hemicolectomy are the best therapy. Angiographic procedures are of importance to determine the site of bleeding, stabilize the bleeding with the use of vasoconstrictor drug therapy, and to plan the surgical treatment.