Atypical presentation of perforated sigmoid diverticulitis in a kidney transplant recipient with autosomal dominant polycystic kidney disease.

Abstract

Perforated sigmoid diverticulitis, a complication of colonic diverticulosis commonly associated with autosomal dominant polycystic kidney disease (ADPKD), can be life-threatening in allogeneic kidney transplant recipients in the postoperative period. Immunosuppressive medications not only place the patient at risk for intestinal perforation, but also mask classic clinical symptoms and signs of acute abdomen, and subsequently lead to delayed diagnosis and treatment. We report a case of an ADPKD patient post kidney transplantation presenting with nausea, vomiting, and abdominal pain without signs of peritonitis. Chest x-ray revealed free air under the diaphragm consistent with intestinal perforation. Post kidney transplant recipients with ADPKD presenting with abdominal pain should prompt a search for possible perforated colonic diverticulitis in order to diagnose and treat this life-threatening condition early.

• Authors: Ekamol Tantisattamo, Antonio Guasch
• Journal: Hawai'i journal of medicine & public health : a journal of Asia Pacific Medicine & Public Health (Hawaii J Med Public Health) Vol. 72 Issue 7 Pg. 216-8 (Jul 2013) ISSN: 2165-8242 [Electronic] United States
• PMID: 23901392 (Publication Type: Case Reports, Journal Article)

Topics

• Colon, Sigmoid
• Diverticulitis, Colonic (complications, diagnosis, surgery)
• Humans
• Intestinal Perforation (complications, diagnosis, surgery)
• Kidney Transplantation
• Male
• Middle Aged
• Polycystic Kidney, Autosomal Dominant (complications, surgery)