Limits...
Deceased donor liver transplantation performed one week after small bowel resection for complicated umbilical hernia: a case report.

Kwon HJ, Chun JM, Kim SG, Kim HK, Huh S, Hwang YJ - Korean J Hepatobiliary Pancreat Surg (2014)

Bottom Line: Emergent abdominal surgery in cirrhotic patients with ascites can result in dismal postoperative outcomes such as sepsis and hepatic failure.In the present case, small bowel resection followed by anastomosis by the hand-sewn method was performed for small bowel strangulation caused by an umbilical hernia; deceased donor liver transplantation was performed one week after the bowel resection because of deterioration of hepatic function.To the best of our knowledge, this is the first case of liver transplantation performed at only one week after small bowel resection; and although we obtained a good result, the optimal time to perform liver transplantation in this situation requires further evaluation.

View Article: PubMed Central - PubMed

Affiliation: Hepatobiliary-Pancreatic Center, Kyungpook National University Medical Center, Korea.

ABSTRACT
Emergent abdominal surgery in cirrhotic patients with ascites can result in dismal postoperative outcomes such as sepsis and hepatic failure. In the present case, small bowel resection followed by anastomosis by the hand-sewn method was performed for small bowel strangulation caused by an umbilical hernia; deceased donor liver transplantation was performed one week after the bowel resection because of deterioration of hepatic function. To the best of our knowledge, this is the first case of liver transplantation performed at only one week after small bowel resection; and although we obtained a good result, the optimal time to perform liver transplantation in this situation requires further evaluation.

No MeSH data available.


Related in: MedlinePlus

Contrast-enhanced abdominal computed tomography scans of the patient showing large amount of ascites and incarcerated small bowel in the umbilical hernia. Axial view (A) and Coronal view (B).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4492321&req=5

Figure 1: Contrast-enhanced abdominal computed tomography scans of the patient showing large amount of ascites and incarcerated small bowel in the umbilical hernia. Axial view (A) and Coronal view (B).

Mentions: In October 2009, a 64-year-old male who have been listed on the KONOS (Korean Network for Organ Sharing) was referred to our hospital for acute-onset abdominal pain. He was diagnosed with hepatocellular carcinoma (HCC) in 2007, and transarterial chemoembolization (TACE) was performed four times for the management of HCC. After receiving the fourth TACE, ascites could not be controlled with conservative therapy; and shortly thereafter, he developed an umbilical hernia and suffered from two episodes of spontaneous bacterial peritonitis. On physical examination, there was marked tenderness in the umbilical area and a protruding mass; and he had a Model for End-Stage Liver Disease (MELD) score of 15. His serum bilirubin level was 2.6 mg/dl, INR was 1.63, and serum creatinine level was 0.9 mg/dl. Contrast-enhanced computed tomography scan of the abdomen showed a large amount of ascites and incarcerated small bowel in an umbilical hernia (Fig. 1). On laparotomy, the incarcerated bowel was dull gray or black in color and lacked motility; therefore, we resected the strangulated bowel and performed an end-to-end anastomosis by the hand-sewn method. Primary closure of the hernia defect was performed without placement of abdominal drainage tubes.


Deceased donor liver transplantation performed one week after small bowel resection for complicated umbilical hernia: a case report.

Kwon HJ, Chun JM, Kim SG, Kim HK, Huh S, Hwang YJ - Korean J Hepatobiliary Pancreat Surg (2014)

Contrast-enhanced abdominal computed tomography scans of the patient showing large amount of ascites and incarcerated small bowel in the umbilical hernia. Axial view (A) and Coronal view (B).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4492321&req=5

Figure 1: Contrast-enhanced abdominal computed tomography scans of the patient showing large amount of ascites and incarcerated small bowel in the umbilical hernia. Axial view (A) and Coronal view (B).
Mentions: In October 2009, a 64-year-old male who have been listed on the KONOS (Korean Network for Organ Sharing) was referred to our hospital for acute-onset abdominal pain. He was diagnosed with hepatocellular carcinoma (HCC) in 2007, and transarterial chemoembolization (TACE) was performed four times for the management of HCC. After receiving the fourth TACE, ascites could not be controlled with conservative therapy; and shortly thereafter, he developed an umbilical hernia and suffered from two episodes of spontaneous bacterial peritonitis. On physical examination, there was marked tenderness in the umbilical area and a protruding mass; and he had a Model for End-Stage Liver Disease (MELD) score of 15. His serum bilirubin level was 2.6 mg/dl, INR was 1.63, and serum creatinine level was 0.9 mg/dl. Contrast-enhanced computed tomography scan of the abdomen showed a large amount of ascites and incarcerated small bowel in an umbilical hernia (Fig. 1). On laparotomy, the incarcerated bowel was dull gray or black in color and lacked motility; therefore, we resected the strangulated bowel and performed an end-to-end anastomosis by the hand-sewn method. Primary closure of the hernia defect was performed without placement of abdominal drainage tubes.

Bottom Line: Emergent abdominal surgery in cirrhotic patients with ascites can result in dismal postoperative outcomes such as sepsis and hepatic failure.In the present case, small bowel resection followed by anastomosis by the hand-sewn method was performed for small bowel strangulation caused by an umbilical hernia; deceased donor liver transplantation was performed one week after the bowel resection because of deterioration of hepatic function.To the best of our knowledge, this is the first case of liver transplantation performed at only one week after small bowel resection; and although we obtained a good result, the optimal time to perform liver transplantation in this situation requires further evaluation.

View Article: PubMed Central - PubMed

Affiliation: Hepatobiliary-Pancreatic Center, Kyungpook National University Medical Center, Korea.

ABSTRACT
Emergent abdominal surgery in cirrhotic patients with ascites can result in dismal postoperative outcomes such as sepsis and hepatic failure. In the present case, small bowel resection followed by anastomosis by the hand-sewn method was performed for small bowel strangulation caused by an umbilical hernia; deceased donor liver transplantation was performed one week after the bowel resection because of deterioration of hepatic function. To the best of our knowledge, this is the first case of liver transplantation performed at only one week after small bowel resection; and although we obtained a good result, the optimal time to perform liver transplantation in this situation requires further evaluation.

No MeSH data available.


Related in: MedlinePlus