Skip to main content
PMC home page
Annals of Surgery logoLink to Annals of Surgery
. 1978 Jul;188(1):109–113. doi: 10.1097/00000658-197807000-00018

Colon perforation after kidney transplantation.

S D Carson, R A Krom, K Uchida, K Yokota, J C West, R Weil 3rd
PMCID: PMC1396627  PMID: 352278

Abstract

Between 1962 and 1977 approximately 2% of Denver kidney transplant patients developed colon perforation. The single commonest cause was diverticulitis of the left colon (6/13 cases). In spite of drastic reduction or discontinuation of immunosuppression, only 5/13 patients survived for more than 90 days after operation. Analysis of this experience suggests that the high mortality rate associated with this complication can be reduced by early operation which removes the perforation from the peritoneal cavity (either exteriorization or resection) without primary intestinal reanastomosis. We believe that candidates for kidney transplantation with a history of previously symptomatic diverticulosis coli should have elective colon resection prior to transplantation. Any kidney transplant patient with lower abdominal signs should be investigated and treated aggressively.

Full text

PDF
113

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aaron K. E., Dailey T. H. Survival after colonic perforation of a patient with a transplanted kidney: report of a case. Dis Colon Rectum. 1974 Jan-Feb;17(1):103–105. doi: 10.1007/BF02587550. [DOI] [PubMed] [Google Scholar]
  2. Arvanitakis C., Malek G., Uehling D., Morrissey J. F. Colonic complications after renal transplantation. Gastroenterology. 1973 Apr;64(4):533–538. [PubMed] [Google Scholar]
  3. Bernstein W. C., Nivatvongs S., Tallent M. B. Colonic and rectal complications of kidney transplantation in man. Dis Colon Rectum. 1973 Jul-Aug;16(4):255–263. doi: 10.1007/BF02587698. [DOI] [PubMed] [Google Scholar]
  4. Canter J. W., Shorb P. E., Jr Acute perforation of colonic diverticula associated with prolonged adrenocorticosteroid therapy. Am J Surg. 1971 Jan;121(1):46–51. doi: 10.1016/0002-9610(71)90076-6. [DOI] [PubMed] [Google Scholar]
  5. Classen J. N., Bonardi R., O'Mara C. S., Finney D. C., Sterioff S. Surgical treatment of acute diverticulitis by staged procedures. Ann Surg. 1976 Nov;184(5):582–586. doi: 10.1097/00000658-197611000-00008. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Demling R. H., Salvatierra O., Jr, Belzer F. O. Intestinal necrosis and perforation after renal transplantation. Arch Surg. 1975 Mar;110(3):251–253. doi: 10.1001/archsurg.1975.01360090021004. [DOI] [PubMed] [Google Scholar]
  7. Hadjiyannakis E. J., Smellie W. A., Evans D. B., Calne R. Y. Gastrointestinal complications after renal transplantation. Lancet. 1971 Oct 9;2(7728):781–785. doi: 10.1016/s0140-6736(71)92739-5. [DOI] [PubMed] [Google Scholar]
  8. Hognestad J., Flatmark A. Colon perforation in renal transplant patients. Scand J Gastroenterol. 1976;11(3):289–292. [PubMed] [Google Scholar]
  9. Misra M. K., Pinkus G. S., Birtch A. G., Wilson R. E. Major colonic diseases complicating renal transplantation. Surgery. 1973 Jun;73(6):942–948. [PubMed] [Google Scholar]
  10. Penn I., Brettschneider L., Simpson K., Martin A., Starzl T. E. Major colonic problems in human homotransplant recipients. Arch Surg. 1970 Jan;100(1):61–65. doi: 10.1001/archsurg.1970.01340190063013. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Penn I., Groth C. G., Brettshneider L., Martin A. J., Jr, Marchioro T. L., Starzi T. E. Surgically correctable intra-abdominal complications before and after renal homotransplantation. Ann Surg. 1968 Nov;168(5):865–870. doi: 10.1097/00000658-196811000-00012. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Powis S. J., Barnes A. D., Dawson-Edwards P., Thompson H. Ileocolonic problems after cadaveric renal transplantation. Br Med J. 1972 Jan 8;1(5792):99–101. doi: 10.1136/bmj.1.5792.99. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Sterioff S., Orringer M. B., Cameron J. L. Colon perforations associated with steroid therapy. Surgery. 1974 Jan;75(1):56–58. [PubMed] [Google Scholar]
  14. Sutherland D., Frech R. S., Weil R., Najarian J. S., Simmons R. L. The bleeding cecal ulcer: pathogenesis, angiographic diagnosis, and nonoperative control. Surgery. 1972 Feb;71(2):290–294. [PubMed] [Google Scholar]
  15. Thompson W. M., Seigler H. F., Rice R. P. Ileocolonic perforation. A complication following renal transplantation. Am J Roentgenol Radium Ther Nucl Med. 1975 Nov;125(3):723–730. doi: 10.2214/ajr.125.3.723. [DOI] [PubMed] [Google Scholar]
  16. Warshaw A. L., Welch J. P., Ottinger L. W. Acute perforation of the colon associated with chronic corticosteroid therapy. Am J Surg. 1976 Apr;131(4):442–446. doi: 10.1016/0002-9610(76)90154-9. [DOI] [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES