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Aortic Graft Mycotic Pseudoaneurysm as a Severe Complication After Multivisceral Transplantation: A Case Report
- Source :
- Transplantation proceedings. 48(2)
- Publication Year :
- 2015
-
Abstract
- Background Surgical complications in multivisceral transplantation (MVT) are frequent and always severe. Those related to technical issues are relevant as they have implications not only on the graft but also on patient survival. The aim of this study was to review our case-based data and experience with 5 MVT performed since December 2004. Case Report A 38 year-old woman presented with ultra-short bowel syndrome due to massive ischemia also affecting the celiac trunk. She also had moderate to severe hepatitis/steatosis with some degree of fibrosis on liver biopsy, due to long-term home parenteral nutrition (HPN). An MVT was carried out in September 2010 including the liver, stomach, pancreatoduodenal complex with the spleen, and small bowel. The postoperative course was complicated by a leak from the pyloromiotomy, requiring reoperation on postoperative day 13. She also had central line catheter infection and renal impairment, requiring renal replacement therapy, and was discharged on postoperative day 150. Fifteen days later she was hospitalized because of severe abdominal pain associated with an abdominal mass. Computed tomography showed an aortic donor graft pseudoaneurysm, so we decided to operate on the patient. A complete resection of the pseudoaneurysm using an interposed polytetrafluoroethylene graft was performed. Six months after the MVT, the patient died due to sepsis, despite a functional graft and complete digestive autonomy. Conclusions Although this complication is rare, surgical complications in MVT are severe and may seriously impair graft and patient survival.
- Subjects :
- Adult
Reoperation
Short Bowel Syndrome
Abdominal pain
medicine.medical_specialty
medicine.medical_treatment
Liver transplantation
Pseudoaneurysm
Blood vessel prosthesis
Intestine, Small
medicine
Humans
Renal replacement therapy
Transplantation
Aortic Aneurysm, Thoracic
business.industry
Short bowel syndrome
medicine.disease
Abdominal mass
Surgery
Blood Vessel Prosthesis
Liver Transplantation
Female
medicine.symptom
Complication
business
Aneurysm, Infected
Aneurysm, False
Subjects
Details
- ISSN :
- 18732623
- Volume :
- 48
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Transplantation proceedings
- Accession number :
- edsair.doi.dedup.....2aefaaf7f5e23ceaf5258f44f69385b7