Thongprayoon Charat, Cheungpasitporn Wisit, Edmonds Peter J, Thamcharoen Natanong
Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
SUNY Upstate Medical University, Syracuse, New York, USA.
N Am J Med Sci. 2014 Nov;6(11):599-600. doi: 10.4103/1947-2714.145484.
Jejunal diverticulosis is a rare disease. Common acute complications include diverticulitis, intestinal obstruction, bleeding and perforation. Gastrointestinal tract perorations have also been rarely observed in the use of mycophenolate mofetil.
We report a 44-year-old man with end-stage renal disease post failed kidney transplant on low-dose mycophenolate mofetil who presented with acute onset of abdominal pain. He was successfully given the diagnosis of perforated jejunal diverticulum. The patient successfully underwent a segmental jejunal resection and anastomosis. He unfortunately developed a recurrent jejunal perforation a month later and again had the second segmental jejunal resection operation. Mycophenolate mofetil then was discontinued.
The present case illustrates jejunal diverticulum perforation in the use of mycophenolate mofetil. Physicians should increase the awareness of this association of perforated jejunal diverticulum in patients using mycophenolate mofetil.
空肠憩室病是一种罕见疾病。常见的急性并发症包括憩室炎、肠梗阻、出血和穿孔。在使用吗替麦考酚酯时也很少观察到胃肠道穿孔。
我们报告一名44岁男性，肾移植失败后处于终末期肾病，服用低剂量吗替麦考酚酯，出现急性腹痛。他被成功诊断为空肠憩室穿孔。患者成功接受了节段性空肠切除及吻合术。不幸的是，一个月后他出现了复发性空肠穿孔，再次接受了节段性空肠切除手术。随后停用了吗替麦考酚酯。
本病例说明了使用吗替麦考酚酯时空肠憩室穿孔的情况。医生应提高对使用吗替麦考酚酯患者发生空肠憩室穿孔这种关联的认识。
