ABSTRACT
Spontaneous renal allograft rupture is an uncommon complication of renal transplantation, but it represents a life-threatening emergency that requires prompt recognition and treatment. The incidence of spontaneous renal allograft rupture is variable and range between 3.6 and 9.6 percent of all transplants. In the majority of cases the rupture is associated with acute rejection episodes and with renal vein thrombosis. Most frequently, the allograft rupture occurs within the first 2 weeks of transplantation. in addition, most ruptures reported have occurred in cadaveric renal allograft. Debate on the management of such allograft salvage versus transplant nephrectomy. It appears that the recent trend is toward performing surgical repair of the graft if the rupture is secondary to rejection and oo evidence of renal vein thrombosis ; otherwise, graft nephrectomy be done. We report a case of spontaneous renal allograft rupture due to renal vein thrombosis occurred in a 21-year-old woman 6 days after transplantation. Unusual severe localized pain, swelling over at allograft site, and hypotension, a triad frequently seen in renal allograft rupture, were present. Management by graft nephrectomy was inevitable because of the patient's downhill course.
Subject(s)
Female , Humans , Young Adult , Allografts , Cadaver , Emergencies , Hypotension , Incidence , Kidney Transplantation , Nephrectomy , Renal Veins , Rupture , Rupture, Spontaneous , Thrombosis , TransplantsABSTRACT
Stenosing papillitis is a descriptive term for an anatomic deformity of the Ampulla of Vater due to chronic inflammation and fibrosis, which is characterized by narrowing of the lower end of the bile and pancreatic duct, and by clinical symptoms resembling pancreticobiliary disease. Duodenoscopic finding of "stenosing papillitis" usually shows edema, erythema, and laceration on Ampulla of Vater, but endoscopic finding such as polypoid mass is rare. We recently experienced one case of polypoid stenosing papillitis and report with a review of relevant literatures A 54-year-old man was admitted to our hospital because of chronic right upper abdominal pain for 2 years. Duodenoscopy re-vealed a polypoid mass with erythemaous color change on Ampulla of Vater, which was endoscopically resected by using a polypectomy snare, and pathologic examination showed chronic inflammation and fibrosis.
Subject(s)
Humans , Middle Aged , Abdominal Pain , Ampulla of Vater , Bile , Congenital Abnormalities , Duodenoscopy , Edema , Erythema , Fibrosis , Inflammation , Lacerations , Pancreatic Ducts , Papilledema , SNARE ProteinsABSTRACT
Cholestatic jaundice caused by imidazole derivatives is a rare complication of antithyroid drug therapy. We present a case of cholestatic jaundice with systemic hypersensitivity reaction, which developed in a 27-year old male one day after exposure to methimazole. The patient showed clinical improvement and gradual resolution of jaundice after the discontinuation of methimazole and treatment with prednisolone. Histologic findings of liver revealed bile pigment, predominantly in centrilobular area, and infiltration of chronic inflammatory cells in a few portal area without evidence of degeneration or necrosis of hepatocytes. Methimazole could be presumed as etiologic agent from clear chronological relationship and the lack of other causative factors. We report this unusual case with review of literature.