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Emergency surgical treatment of complicated acute pancreatitis after kidney transplantation with acute rejection: Case report and literature review

INTRODUCTION: Acute pancreatitis is a rare but frequently fatal complication in patients following kidney transplantation. The first case of acute pancreatitis in patients following a kidney transplant was described by Starzl in 1964. The incidence of acute pancreatitis is stated at between 1 and 5%...

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Autores principales: Klos, Dušan, Orság, Jiří, Loveček, Martin, Skalický, Pavel, Havlík, Roman, Zadražil, Josef, Neoral, Čestmír
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4878847/
https://www.ncbi.nlm.nih.gov/pubmed/27257480
http://dx.doi.org/10.1016/j.amsu.2016.04.022
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author Klos, Dušan
Orság, Jiří
Loveček, Martin
Skalický, Pavel
Havlík, Roman
Zadražil, Josef
Neoral, Čestmír
author_facet Klos, Dušan
Orság, Jiří
Loveček, Martin
Skalický, Pavel
Havlík, Roman
Zadražil, Josef
Neoral, Čestmír
author_sort Klos, Dušan
collection PubMed
description INTRODUCTION: Acute pancreatitis is a rare but frequently fatal complication in patients following kidney transplantation. The first case of acute pancreatitis in patients following a kidney transplant was described by Starzl in 1964. The incidence of acute pancreatitis is stated at between 1 and 5%. The mortality rate amongst these patients reaches as high as 50–100%. PRESENTATION OF CASE: Here we present a case of acute pancreatic abscess in a caucasian female – shortly following a kidney transplant complicated by the development of acute rejection, in which immunosuppressant therapy is a potential etiological agent. Emergency surgical treatment was indicated, which included drainage of the abscesses irrigation of the abdominal cavity. Immunosuppressive medication was considered a possible etiological factor, and as a result administration of tacrolimus and mycophenolate mofetil was discontinued. This was successful and three months later, diagnostic rebiopsy of the graft was performed without signs of rejection. DISCUSSION: The etiology of this illness is multifactorial. The clinical manifestation of acute pancreatitis in patients following kidney transplantation is the same as in the remainder of the population. However, in patients following transplantation with long-term immunosuppression, it usually manifests a more rapid development and a more severe, frequently fatal course. CONCLUSIONS: With regard to the patient's comorbidities, early surgical therapy was indicated – drainage and closed lavage and immunosuppressive medication as a suspected tobe ethiological factor was discontinued. This course of treatment led to a complete recovery with preservation of good function of the cadaverous kidney.
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spelling pubmed-48788472016-06-02 Emergency surgical treatment of complicated acute pancreatitis after kidney transplantation with acute rejection: Case report and literature review Klos, Dušan Orság, Jiří Loveček, Martin Skalický, Pavel Havlík, Roman Zadražil, Josef Neoral, Čestmír Ann Med Surg (Lond) Case Report INTRODUCTION: Acute pancreatitis is a rare but frequently fatal complication in patients following kidney transplantation. The first case of acute pancreatitis in patients following a kidney transplant was described by Starzl in 1964. The incidence of acute pancreatitis is stated at between 1 and 5%. The mortality rate amongst these patients reaches as high as 50–100%. PRESENTATION OF CASE: Here we present a case of acute pancreatic abscess in a caucasian female – shortly following a kidney transplant complicated by the development of acute rejection, in which immunosuppressant therapy is a potential etiological agent. Emergency surgical treatment was indicated, which included drainage of the abscesses irrigation of the abdominal cavity. Immunosuppressive medication was considered a possible etiological factor, and as a result administration of tacrolimus and mycophenolate mofetil was discontinued. This was successful and three months later, diagnostic rebiopsy of the graft was performed without signs of rejection. DISCUSSION: The etiology of this illness is multifactorial. The clinical manifestation of acute pancreatitis in patients following kidney transplantation is the same as in the remainder of the population. However, in patients following transplantation with long-term immunosuppression, it usually manifests a more rapid development and a more severe, frequently fatal course. CONCLUSIONS: With regard to the patient's comorbidities, early surgical therapy was indicated – drainage and closed lavage and immunosuppressive medication as a suspected tobe ethiological factor was discontinued. This course of treatment led to a complete recovery with preservation of good function of the cadaverous kidney. Elsevier 2016-04-29 /pmc/articles/PMC4878847/ /pubmed/27257480 http://dx.doi.org/10.1016/j.amsu.2016.04.022 Text en © 2016 The Author(s) http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Klos, Dušan
Orság, Jiří
Loveček, Martin
Skalický, Pavel
Havlík, Roman
Zadražil, Josef
Neoral, Čestmír
Emergency surgical treatment of complicated acute pancreatitis after kidney transplantation with acute rejection: Case report and literature review
title Emergency surgical treatment of complicated acute pancreatitis after kidney transplantation with acute rejection: Case report and literature review
title_full Emergency surgical treatment of complicated acute pancreatitis after kidney transplantation with acute rejection: Case report and literature review
title_fullStr Emergency surgical treatment of complicated acute pancreatitis after kidney transplantation with acute rejection: Case report and literature review
title_full_unstemmed Emergency surgical treatment of complicated acute pancreatitis after kidney transplantation with acute rejection: Case report and literature review
title_short Emergency surgical treatment of complicated acute pancreatitis after kidney transplantation with acute rejection: Case report and literature review
title_sort emergency surgical treatment of complicated acute pancreatitis after kidney transplantation with acute rejection: case report and literature review
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4878847/
https://www.ncbi.nlm.nih.gov/pubmed/27257480
http://dx.doi.org/10.1016/j.amsu.2016.04.022
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