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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2018
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.
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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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