Anastomotic ulceration following small bowel transplantation

D. Turner, S. Martin, B. Y. Ngan, D. Grant, P. M. Sherman*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

We describe, for the first time, anastomotic ulcers (AU) following bowel transplantation at the Hospital for Sick Children. Two children presented with rectal bleeding, 6 and 9 months, following the transplantation. Isolated ulcers were identified at the ileo-colonic and the colo-colonic anastomosis site. The ulcers resolved, but recurred 6 and 7 months after the initial presentation. Both patients were positive for adenovirus in the stool and were treated with rapamycin. The histology revealed granulation tissue formation with mild inflammation in the adjacent mucosa, without evidence of rejection or infection. A literature search revealed 10 studies reporting 29 patients who developed AU following various surgical etiologies, none of which was bowel transplant. Numerous factors that are unique to the post-transplant period may predispose to such ulcer and are discussed in detail. Physicians and surgeons should be aware of this multifactorial complication, among other etiologies, as a cause of anemia or rectal bleeding following intestinal transplantation.

Original languageAmerican English
Pages (from-to)236-240
Number of pages5
JournalAmerican Journal of Transplantation
Volume6
Issue number1
DOIs
StatePublished - Jan 2006
Externally publishedYes

Keywords

  • Anastomosis
  • Hematochezia
  • Rapamycin
  • Sirolimus
  • Transplant
  • Ulcers

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