Internal hernia of the small intestine around biliary catheter after living-donor liver transplantation: A case report
•Biliary reconstruction is a cornerstone of LDLT.•The use of trans-anastomotic biliary catheters is controversial.•We describe a rare case of intestinal obstruction due to internal herniation around biliary catheter.•Awareness of this complication plus early surgical intervention can prevent postope...
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| Veröffentlicht in: | International journal of surgery case reports 2018-01, Vol.49, p.158-162 |
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| creator | 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 |
| description | •Biliary reconstruction is a cornerstone of LDLT.•The use of trans-anastomotic biliary catheters is controversial.•We describe a rare case of intestinal obstruction due to internal herniation around biliary catheter.•Awareness of this complication plus early surgical intervention can prevent postoperative morbidity and mortality.
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.
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.
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.
We report the first case of internal herniation of small bowel around biliary catheter early after LDLT. |
| doi_str_mv | 10.1016/j.ijscr.2018.06.023 |
| format | Article |
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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.
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.
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.
We report the first case of internal herniation of small bowel around biliary catheter early after LDLT.</description><identifier>ISSN: 2210-2612</identifier><identifier>EISSN: 2210-2612</identifier><identifier>DOI: 10.1016/j.ijscr.2018.06.023</identifier><identifier>PMID: 30007264</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Intestinal obstruction ; Living donor liver transplantation ; Trans-anastomotic biliary catheter</subject><ispartof>International journal of surgery case reports, 2018-01, Vol.49, p.158-162</ispartof><rights>2018 The Authors</rights><rights>Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.</rights><rights>2018 The Authors 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c409t-79b70c95bc371d5533f8a0f50d9e87ea53c784c17e2effc5d52784450174a51b3</cites><orcidid>0000-0002-9184-8597</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6068080/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ijscr.2018.06.023$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>230,315,729,782,786,887,3554,27933,27934,46004,53800,53802</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30007264$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Abdel Wahab, Mohamed</creatorcontrib><creatorcontrib>Shehta, Ahmed</creatorcontrib><creatorcontrib>Adly, Reham</creatorcontrib><creatorcontrib>Elshoubary, Mohamed</creatorcontrib><creatorcontrib>Salah, Tarek</creatorcontrib><creatorcontrib>Yassen, Amr M.</creatorcontrib><creatorcontrib>Elmorshedi, Mohamed</creatorcontrib><creatorcontrib>Emara, Moataz M.</creatorcontrib><creatorcontrib>Abdelkhalek, Mostafa</creatorcontrib><creatorcontrib>Elsedeiq, Mahmoud</creatorcontrib><creatorcontrib>Shiha, Usama</creatorcontrib><creatorcontrib>Elghawalby, Ahmed N.</creatorcontrib><creatorcontrib>Eldesoky, Mohamed</creatorcontrib><creatorcontrib>Monier, Ahmed</creatorcontrib><creatorcontrib>Said, Rami</creatorcontrib><title>Internal hernia of the small intestine around biliary catheter after living-donor liver transplantation: A case report</title><title>International journal of surgery case reports</title><addtitle>Int J Surg Case Rep</addtitle><description>•Biliary reconstruction is a cornerstone of LDLT.•The use of trans-anastomotic biliary catheters is controversial.•We describe a rare case of intestinal obstruction due to internal herniation around biliary catheter.•Awareness of this complication plus early surgical intervention can prevent postoperative morbidity and mortality.
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.
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.
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.
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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.
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.
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.
We report the first case of internal herniation of small bowel around biliary catheter early after LDLT.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>30007264</pmid><doi>10.1016/j.ijscr.2018.06.023</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0002-9184-8597</orcidid><oa>free_for_read</oa></addata></record> |
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| language | eng |
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| source | Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Access via ScienceDirect (Elsevier); PubMed Central |
| subjects | Intestinal obstruction Living donor liver transplantation Trans-anastomotic biliary catheter |
| title | Internal hernia of the small intestine around biliary catheter after living-donor liver transplantation: A case report |
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