Brown Sherry-Ann N, Dean Patrick G, Hickson LaTonya J
Division of Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN USA.
Division of Transplantation Surgery, Department of Surgery, Mayo Clinic, Rochester, MN USA.
Springerplus. 2015 Aug 22;4:445. doi: 10.1186/s40064-015-1229-7. eCollection 2015.
Among kidney transplant recipients with acute kidney injury, the differential diagnosis must be broadened to include conditions such as rejection, immunocompromised host infections, anatomic pathologies, and recurrent or de novo glomerular diseases. In this case report, we describe an unusual cause of acute renal allograft injury due to external compression of the allograft ureter.
Retrospective review; case report.
The patient developed acute kidney injury of the renal allograft due to external compression of the allograft ureter coincident with a cecal volvulus. The patient underwent lysis of adhesions, right hemicolectomy, and end ileostomy creation with resolution of acute kidney injury.
Cecal volvulus is an uncommon cause of bowel obstruction and is often associated with adhesions following abdominal surgery. To our knowledge, cecal volvulus has not previously been reported as a direct contributor to acute kidney injury. This case highlights the need for a systematic approach to the patient with acute kidney injury and the special considerations involved in the diagnosis of renal failure in the kidney transplant population.
在急性肾损伤的肾移植受者中,鉴别诊断范围必须扩大,以包括诸如排斥反应、免疫功能低下宿主感染、解剖学病变以及复发性或新发肾小球疾病等情况。在本病例报告中,我们描述了一种因移植肾输尿管外部受压导致急性移植肾损伤的不寻常原因。
回顾性研究;病例报告。
该患者因移植肾输尿管外部受压并发盲肠扭转,出现了移植肾急性肾损伤。患者接受了粘连松解术、右半结肠切除术及末端回肠造口术,急性肾损伤得以缓解。
盲肠扭转是肠梗阻的罕见原因,且常与腹部手术后的粘连有关。据我们所知,此前尚无盲肠扭转作为急性肾损伤直接病因的报道。本病例强调了对急性肾损伤患者采取系统方法的必要性,以及肾移植人群肾衰竭诊断中涉及的特殊考量。