肾移植术后发生回肠穿孔2例报告并文献复习

Ileal perforation following renal transplantation: A report of 2 cases and review of the literature

目的报告2例肾移植术后回肠穿孔并发症,探讨相关危险因素。方法回顾性分析2例肾移植术后回肠穿孔的临床资料,并复习有关文献进行讨论。结果回肠穿孔1例发生在术后第7天,1例发生在术后第19天,发病前均有饮食不洁及暴饮暴食史,临床有腹泻、腹痛及肠梗阻等急腹症表现,经剖腹探查明确回肠穿孔,行肠穿孔修补术,术后应用低剂量抗排异药物,加强引流及抗感染措施,2例患者均治愈,随访4-40个月恢复良好。结论肾移植术后暴饮暴食及饮食不洁可能诱发肠穿孔,应尽可能避免;早期诊断及手术治疗可以改善预后。

Objective To report 2 cases of ileal perforation after kidney transplantation and study its related risk factors.Methods Clinical data about the 2 cases of ileal perforation after kidney transplantation were retrospectively analyzed and its related literature was reviewed.Results Ileal perforation occurred 7 and 19 days,respectively,in the 2 cases after renal transplantation.The two cases,with a history of dirty diet and craputence before onset of ileal perforation,had the clinical manifestations of acute abdomen,such as diarrhea,abdominal pain,and intestinal obstruction,and were diagnosed as ileal performation at exploratory laparotomy and underwent neoplasty.The patients recovered quite well after anti-rejection and anti-infection treatment with adequate drainage after operation,and were followed up for 4-40 months.Conclusion Dirty diet and craputence can induce intestinal perforation after kidney transplantation,which should be avoided as far as possible.Early diagnosis and surgical treatment can improve the prognosis of such patients.