Sannomiya Akihito, Nakajima Ichiro, Ogawa Yuichi, Kai Kotaro, Koyama Ichiro, Fuchinoue Shohei
Department of Surgery, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan.
Case Rep Transplant. 2017;2017:5681251. doi: 10.1155/2017/5681251. Epub 2017 Apr 5.
A 45-year-old woman with type 1 diabetes and chronic renal failure on dialysis underwent simultaneous pancreas-kidney transplantation from a brain dead donor. On postoperative day 15, acute generalized peritonitis was diagnosed and emergency laparotomy was performed. Perforation of the donor duodenum was found, which had apparently resulted from duodenal compression by the tip of the intestinal fistula tube placed for decompression. The perforation was sutured and the intestinal fistula tube was exchanged. Following this, perforation repeatedly recurred at the same site and open repair at laparotomy was required a total of four times. The fourth operation involved both suturing the perforation and covering it with ileum, after which there was no further recurrence. The patient was discharged on posttransplantation day 219, with the pancreas and kidney grafts both functioning well. This report presents a rare complication of simultaneous pancreas-kidney transplantation.
一名患有1型糖尿病和慢性肾衰竭且正在接受透析的45岁女性，接受了来自脑死亡供体的胰肾联合移植手术。术后第15天，诊断为急性弥漫性腹膜炎并进行了急诊剖腹手术。发现供体十二指肠穿孔，显然是由用于减压的肠瘘管尖端压迫十二指肠所致。对穿孔进行了缝合，并更换了肠瘘管。此后，同一部位反复出现穿孔，共进行了4次剖腹手术进行开放修复。第四次手术包括缝合穿孔并用回肠覆盖，此后未再复发。患者于移植后第219天出院，胰腺和肾移植均功能良好。本报告介绍了胰肾联合移植的一种罕见并发症。
