Acute Apendicitis in Liver Transplant Recipients

Abstract

Background : Appendicitis is a common cause of emergency surgery that in the population undergoing organ transplantation presents a rare incidence due to late diagnosis and treatment. Aim : To report the occurrence of acute appendicitis in a cohort of liver transplant recipients. Methods : Retrospective analysis in a period of 12 years among 925 liver transplants, in witch five cases of acute appendicitis were encountered. Results : Appendicitis occurred between three and 46 months after liver transplantation. The age ranged between 15 and 58 years. There were three men and two women. The clinical presentations varied, but not discordant from those found in non-transplanted patients. Pain was a symptom found in all patients, in two cases well located in the right iliac fossa (40%). Two patients had symptoms characteristic of peritoneal irritation (40%) and one patient had abdominal distention (20%). All patients were submitted to laparotomies. In 20% there were no complications. In 80% was performed appendectomy complicated by suppuration (40%) or perforation (40%). Superficial infection of the surgical site occurred in two patients, requiring clinical management. The hospital stay ranged from 48 h to 45 days. Conclusion : Acute appendicitis after liver transplantation is a rare event being associated with a high rate of drilling, due to delays in diagnosis and therapy, and an increase in hospital stay.

Defining the Burden of Emergency General Surgery in Transplant Patients: A Nationwide Examination

“…8 Fonseca-Neto et al encountered five cases of acute appendicitis among 925 liver transplants over a 12-y period. 18 Soravia et al identified 12 patients among a cohort of 2091 renal allograft recipients who developed acute colonic complications. 19 A retrospective analysis by Ooms et al of 1564 kidney recipients demonstrated that 50 patients (3.2%) developed an incisional hernia.…”

Acute Appendicitis in the Early Stage after Orthotopic Liver Transplantation

“…The reported incidence of acute appendicitis in liver transplant recipients is 0.01–0.49%. [ 1 2 ] de’Angelis et al . [ 1 ] reported that only 2% of solid organ transplant patients experienced appendicitis, and the median time from transplantation to emergency surgery was 2.4 years (range: 0.1–20.0 years).…”

“…In this study, the patients had acute appendicitis in the early stage after OLT (POD 9 and POD 11), which is much earlier than previous reports. [ 1 2 ] However, the risk factors remain unclear.…”

Acute abdomen in the immunocompromised patient: WSES, SIS-E, WSIS, AAST, and GAIS guidelines

“…In liver transplanted patients, cumulative incidence of AA ranges from 0.09 to 0.54% [ 82 , 92 – 94 , 96 ] demonstrating the rarity of this pathology in LT. In a recent meta-analysis, AA accounted only for 2% of all emergency surgery in transplanted patients [ 97 ].…”