Acute diverticulitis in heart- and lung transplant patients

Khan, Shahzad Alam; Eppstein, Andrew C.; Anderson, Gina K.; Dengal, M. K.; Eggenberger, John C.; Lee, C. S.; Szilagy, Eric J.; Margolin, David A.

doi:10.1111/j.1432-2277.2001.tb00003.x

Cited by 17 publications

(9 citation statements)

References 11 publications

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“…They were carried out in ten different countries, particularly in Europe ( n = 11) [13, 14, 18, 24, 28–30, 34, 35, 38, 40], North America ( n = 24) [2, 4, 11, 12, 15–17, 19, 21–23, 25–27, 31, 33, 36, 37, 39, 41, 43–46], Asia and Pacific ( n = 4) [20, 32, 42, 47]. The overall number of transplanted patients considered was 71671.…”

Section: Resultsmentioning

confidence: 99%

Emergency abdominal surgery after solid organ transplantation: a systematic review

et al. 2016

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AimsDue to the increasing number of solid organs transplantations, emergency abdominal surgery in transplanted patients is becoming a relevant challenge for the general surgeon. The aim of this systematic review of the literature is to analyze morbidity and mortality of emergency abdominal surgery performed in transplanted patients for graft-unrelated surgical problems.MethodsThe literature search was performed on online databases with the time limit 1990–2015. Studies describing all types of emergency abdominal surgery in solid organ transplanted patients were retrieved for evaluation.ResultsThirty-nine case series published between 1996 and 2015 met the inclusion criteria and were selected for the systematic review. Overall, they included 71671 transplanted patients, of which 1761 (2.5 %) underwent emergency abdominal surgery. The transplanted organs were the heart in 65.8 % of patients, the lung in 22.1 %, the kidney in 9.5 %, and the liver in 2.6 %. The mean patients’ age at the time of the emergency abdominal surgery was 49.4 ± 7.4 years, and the median time from transplantation to emergency surgery was 2.4 years (range 0.1–20). Indications for emergency abdominal surgery were: gallbladder diseases (80.3 %), gastrointestinal perforations (9.2 %), complicated diverticulitis (6.2 %), small bowel obstructions (2 %), and appendicitis (2 %). The overall mortality was 5.5 % (range 0–17.5 %). The morbidity rate varied from 13.6 % for gallbladder diseases to 32.7 % for complicated diverticulitis. Most of the time, the immunosuppressive therapy was maintained unmodified postoperatively.ConclusionsEmergency abdominal surgery in transplanted patients is not a rare event. Although associated with relevant mortality and morbidity, a prompt and appropriate surgery can lead to satisfactory results if performed taking into account the patient’s immunosuppression therapy and hemodynamic stability.

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Section: Resultsmentioning

confidence: 99%

Emergency abdominal surgery after solid organ transplantation: a systematic review

et al. 2016

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“…13,16 -18,24,31 One study did not specify whether the patients had perforated diverticulitis. 22 Four studies examined a mixture of patients with perforated and nonperforated diverticulitis. 4,6,14,19 These 4 studies did not specify which signs or symptoms were associated with the perforated vs the nonperforated group; thus, we were unable to distinguish the signs and symptoms between perforated diverticulitis and nonperforated diverticulitis.…”

Section: Findings From Included Studiesmentioning

confidence: 99%

“…Of the 151 patients included in the studies in Table 6, only 9 patients (6%) did not receive any surgical treatment throughout their entire disease course. 4,5,11,22,23,32 In the study by Warshaw et al, 11 2 patients received only conservative medical treatment and subsequently died. In both of these patients, perforation was diagnosed on the basis of postmortem examination.…”

Section: Treatment Outcomesmentioning

confidence: 99%

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Diverticulitis in Transplant Patients and Patients on Chronic Corticosteroid Therapy: A Systematic Review

Hwang

Cannom

Abbas

et al. 2010

Diseases of the Colon &Amp; Rectum

120

110

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“…Other speculative inciting factors include bowel wall ischemia during the perioperative period of transplantation and increased intraluminal pressure due to narcotic-induced constipation and the use of bowel stimulants [141]. While bowel wall ulceration and perforation by CMV infection is also a plausible mechanism, numerous cases have failed to detect viral pathology [141,148].…”

Section: Nonpulmonary Critical Care Issuesmentioning

confidence: 99%

Critical Care Aspects of Lung Transplant Patients

Chakinala

Kollef

Trulock

2002

J Intensive Care Med

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Chakinala MM, Kollef MH, Trulock EP. Critical care aspects of lung transplant patients. J Intensive Care Med 2002;17:8–33. Major strides have been made in lung transplantation during the 1990s and it has become an established treatment option for patients with advanced lung disease. Due to improvements in organ preservation, surgical techniques, postoperative intensive care, and immunosuppression, the risk of perioperative and early mortality (less than 3 months after transplantation) has declined [1]. The transplant recipient now has a greater chance of realizing the benefits of the long and arduous waiting period. Despite these improvements, suboptimal long‐term outcomes continue to be shaped by issues such as opportunistic infections and chronic rejection. Because of the wider use of lung transplantation and the longer life span of recipients, intensivists and ancillary intensive care unit (ICU) staff should be well versed with the care of lung transplant recipients. In this clinical review, issues related to organ donation will be briefly mentioned. The remaining focus will be on the critical care aspects of lung transplant recipients in the posttransplant period, particularly ICU management of frequently encountered conditions. First, the groups of patients undergoing transplantation and the types of procedures performed will be outlined. Specific issues directly related to the allograft, including early graft dysfunction from ischemia‐reperfusion injury, airway anastomotic complications, and infections in the setting of immunosuppression will be emphasized. Finally nonpulmonary aspects of posttransplant care and key pharmacologic points in the ICU will be covered.

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Acute diverticulitis in heart- and lung transplant patients

Cited by 17 publications

References 11 publications

Emergency abdominal surgery after solid organ transplantation: a systematic review

Emergency abdominal surgery after solid organ transplantation: a systematic review

Diverticulitis in Transplant Patients and Patients on Chronic Corticosteroid Therapy: A Systematic Review

Critical Care Aspects of Lung Transplant Patients

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