Ischemic bowel disease following bilateral nephrectomy or renal transplant.
Ischemic bowel disease following bilateral nephrectomy or renal transplant.
复制标题
双侧肾切除术或肾移植后的缺血性肠病。
作者：
Margolis Dm;Edward E. Etheredge;R. Garza;Keith A. Hruska;Charles B. Anderson
在2年的时间里，5例患者在肾移植或双侧肾切除准备移植后发生病理证实的缺血性肠病（IBD）。该实体占该移植单位所有主要胃肠道并发症的42%。3例患者出现腹痛和肠梗阻，2例患者出现下消化道大出血。所有5例患者均患有非闭塞性缺血性疾病，因为在任何情况下都无法记录主要肠血管阻塞。每例患者均接受肠切除术治疗，5例患者中有3例存活。虽然脓毒症、休克和大剂量免疫抑制药物与IBD的易感性有关，但这些因素在我们的病例中并不一致。血容量再分布伴短暂性低血压发作，尤其是在术后血液透析期间，可能是显著的。尿毒症患者的IBD可在存在或不存在肾移植的情况下发生，并且可能是这些个体中大量肠出血的原因。
In a 2 year period five patients developed pathologically proved ischemic bowel disease (IBD) following either renal transplantation or bilateral nephrectomy in preparations 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 two patients developed massive lower gastrointestinal hemorrhage. All five 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 three of the five patients survived. Although sepsis, shock, and large doses of immunosuppressive drugs have been implicated in predisposing such patients to IBD, these factors were not uniformly present in our 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.