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Internal hernia of the small intestine around biliary catheter after living-donor liver transplantation: A case report
INTRODUCTION: Biliary reconstruction is a cornerstone of living-donor liver transplantation (LDLT). The routine uses of trans-anastomotic biliary catheters in biliary reconstruction had been a controversial issue. We describe a rare complication related to the use of trans-anastomotic biliary cathet...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6068080/ https://www.ncbi.nlm.nih.gov/pubmed/30007264 http://dx.doi.org/10.1016/j.ijscr.2018.06.023 |
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author | Abdel Wahab, Mohamed Shehta, Ahmed Adly, Reham Elshoubary, Mohamed Salah, Tarek Yassen, Amr M. Elmorshedi, Mohamed Emara, Moataz M. Abdelkhalek, Mostafa Elsedeiq, Mahmoud Shiha, Usama Elghawalby, Ahmed N. Eldesoky, Mohamed Monier, Ahmed Said, Rami |
author_facet | Abdel Wahab, Mohamed Shehta, Ahmed Adly, Reham Elshoubary, Mohamed Salah, Tarek Yassen, Amr M. Elmorshedi, Mohamed Emara, Moataz M. Abdelkhalek, Mostafa Elsedeiq, Mahmoud Shiha, Usama Elghawalby, Ahmed N. Eldesoky, Mohamed Monier, Ahmed Said, Rami |
author_sort | Abdel Wahab, Mohamed |
collection | PubMed |
description | INTRODUCTION: Biliary reconstruction is a cornerstone of living-donor liver transplantation (LDLT). The routine uses of trans-anastomotic biliary catheters in biliary reconstruction had been a controversial issue. We describe a rare complication related to the use of trans-anastomotic biliary catheter after LDLT. In this case, intestinal obstruction occurred early after LDLT due to internal herniation of the small bowel around trans-anastomotic biliary catheter. PRESENTATION: A 42 years male patient with end stage liver disease underwent LDLT utilizing a right hemi-liver graft. Biliary reconstruction was done by single duct-to-duct anastomosis over trans-anastomotic biliary catheter. The patient was doing well apart from early postoperative ascites that was managed medically. Three weeks after surgery, the patient developed severe agonizing central abdominal pain not responding to anti-spasmodics and analgesics. The decision was to proceed for surgical exploration. Exploration revealed internal herniation of the small bowel loops around the trans-anastomotic biliary catheter without strangulation. Reduction of the internal hernia was done by releasing the fixation of the biliary catheter from the anterior abdominal wall. Small bowel resection was not required. The patient had smooth postoperative course and was discharged 10 days after surgery. DISCUSSION: Awareness regarding this rare complication plus early surgical intervention can prevent the development of postoperative morbidity and mortality. To the best of our knowledge this is the first report to describe such are complication after LDLT. CONCLUSION: We report the first case of internal herniation of small bowel around biliary catheter early after LDLT. |
format | Online Article Text |
id | pubmed-6068080 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-60680802018-08-02 Internal hernia of the small intestine around biliary catheter after living-donor liver transplantation: A case report Abdel Wahab, Mohamed Shehta, Ahmed Adly, Reham Elshoubary, Mohamed Salah, Tarek Yassen, Amr M. Elmorshedi, Mohamed Emara, Moataz M. Abdelkhalek, Mostafa Elsedeiq, Mahmoud Shiha, Usama Elghawalby, Ahmed N. Eldesoky, Mohamed Monier, Ahmed Said, Rami Int J Surg Case Rep Article INTRODUCTION: Biliary reconstruction is a cornerstone of living-donor liver transplantation (LDLT). The routine uses of trans-anastomotic biliary catheters in biliary reconstruction had been a controversial issue. We describe a rare complication related to the use of trans-anastomotic biliary catheter after LDLT. In this case, intestinal obstruction occurred early after LDLT due to internal herniation of the small bowel around trans-anastomotic biliary catheter. PRESENTATION: A 42 years male patient with end stage liver disease underwent LDLT utilizing a right hemi-liver graft. Biliary reconstruction was done by single duct-to-duct anastomosis over trans-anastomotic biliary catheter. The patient was doing well apart from early postoperative ascites that was managed medically. Three weeks after surgery, the patient developed severe agonizing central abdominal pain not responding to anti-spasmodics and analgesics. The decision was to proceed for surgical exploration. Exploration revealed internal herniation of the small bowel loops around the trans-anastomotic biliary catheter without strangulation. Reduction of the internal hernia was done by releasing the fixation of the biliary catheter from the anterior abdominal wall. Small bowel resection was not required. The patient had smooth postoperative course and was discharged 10 days after surgery. DISCUSSION: Awareness regarding this rare complication plus early surgical intervention can prevent the development of postoperative morbidity and mortality. To the best of our knowledge this is the first report to describe such are complication after LDLT. CONCLUSION: We report the first case of internal herniation of small bowel around biliary catheter early after LDLT. Elsevier 2018-06-28 /pmc/articles/PMC6068080/ /pubmed/30007264 http://dx.doi.org/10.1016/j.ijscr.2018.06.023 Text en © 2018 The Authors 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 | Article Abdel Wahab, Mohamed Shehta, Ahmed Adly, Reham Elshoubary, Mohamed Salah, Tarek Yassen, Amr M. Elmorshedi, Mohamed Emara, Moataz M. Abdelkhalek, Mostafa Elsedeiq, Mahmoud Shiha, Usama Elghawalby, Ahmed N. Eldesoky, Mohamed Monier, Ahmed Said, Rami Internal hernia of the small intestine around biliary catheter after living-donor liver transplantation: A case report |
title | Internal hernia of the small intestine around biliary catheter after living-donor liver transplantation: A case report |
title_full | Internal hernia of the small intestine around biliary catheter after living-donor liver transplantation: A case report |
title_fullStr | Internal hernia of the small intestine around biliary catheter after living-donor liver transplantation: A case report |
title_full_unstemmed | Internal hernia of the small intestine around biliary catheter after living-donor liver transplantation: A case report |
title_short | Internal hernia of the small intestine around biliary catheter after living-donor liver transplantation: A case report |
title_sort | internal hernia of the small intestine around biliary catheter after living-donor liver transplantation: a case report |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6068080/ https://www.ncbi.nlm.nih.gov/pubmed/30007264 http://dx.doi.org/10.1016/j.ijscr.2018.06.023 |
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