Severe diverticulitis after heart, lung, and heart–lung transplantation

Subclinical peritonitis due to perforated sigmoid diverticulitis 14 years after heart-lung transplantation

“…It is reported in 0.4%-8% of solid organ transplanted patients with a 0%-83.3% mortality rate [4,8,11,16,[18][19][20] . However, no case of acute diverticulitis in patients with heart-lung transplantation has been reported before, particularly in young patients.…”

“…However, no case of acute diverticulitis in patients with heart-lung transplantation has been reported before, particularly in young patients. Compared to the general population, heart and lung transplant recipients are at substantially increased risk of experiencing acute diverticulitis [18,20] . In the study of Qasabian et al, all patients with severe diverticulitis survived and death occurred only in a conservatively treated patient in whom a definite diagnosis was not reached until post-mortem examination was made [18] .…”

“…Compared to the general population, heart and lung transplant recipients are at substantially increased risk of experiencing acute diverticulitis [18,20] . In the study of Qasabian et al, all patients with severe diverticulitis survived and death occurred only in a conservatively treated patient in whom a definite diagnosis was not reached until post-mortem examination was made [18] . Diagnosis of diverticulitis poses a significant challenge in the immunosuppressed patients [11,18,19] .…”

“…In the study of Qasabian et al, all patients with severe diverticulitis survived and death occurred only in a conservatively treated patient in whom a definite diagnosis was not reached until post-mortem examination was made [18] . Diagnosis of diverticulitis poses a significant challenge in the immunosuppressed patients [11,18,19] . Symptoms and physical examination usually do not reflect the severity of the disease while signs of infection, such as fever and tachycardia, may be absent.…”

“…Abdominal CT scan is the most reliable modality in determining the location and degree of pathology. A high index of suspicion, prompt diagnosis, reduction of immunosuppression, and early administration of broad spectrum antibiotics are essential for management and prognosis of these patients [11,[18][19][20] . If bowel perforation is suspected, immediate operative intervention with bowel resection and colostomy is indicated.…”