ISCHEMIC BOWEL-DISEASE FOLLOWING BILATERAL-NEPHRECTOMY OR RENAL-TRANSPLANT

  • 1 January 1977
    • journal article
    • research article
    • Vol. 82  (5) , 667-673
Abstract
In a 2-yr period 5 patients developed pathologically proved ischemic bowel disease (IBD) following either renal transplantation or bilateral nephrectomy in preparation for transplantation. This entity accounted for 42% of all major gastrointestinal complications in this transplant unit. Three patients presented with abdominal pain and ileus, and 2 patients developed massive lower gastrointestinal hemorrhage. All 5 patients had nonocclusive ischemic disease because obstruction of a major intestinal vessel could not be documented in any case. Each patient was treated with bowel resection and 3 of the 5 patients survived. Although sepsis, shock and large doses of immunosuppressive drugs were implicated in predisposing such patients to IBD, these factors were not uniformly present in these cases. Blood volume redistribution with transient episodes of hypotension, especially during postoperative hemodialysis, may be significant. IBD in uremic patients can occur in the presence or absence of renal transplantation and may be the cause of massive intestinal hemorrhage in these individuals.

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