Syndrome of multiple bowel perforations in liver transplant recipients

Wagner C. Marujo, Robert J. Stratta, Alan Norman Langnas, R. Patrick Wood, Rodney Smith Markin, Byers W. Shaw

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

In an analysis of surgical complications following 500 consecutive orthotopic liver transplants, we identified 12 patients who developed the syndrome of multiple bowel perforations that was not due to iatrogenic injury. All cases occurred in small children (mean weight: 9.0 kg), who represented 7% of the pediatric population. Each patient had a minimum of three perforations. The typical intra-operative findings were pin-point perforations in areas of normal-appearing bowel. With only one possible exception (a patient with cytomegalovirus enteritis), no specific etiology could be determined. Management was based on multiple exploratory laparotomies and individualized operative procedures. All patients are currently alive (mean follow-up: 34.9 months). The pathogenesis of the syndrome of multiple bowel perforations remains unclear but is possibly multifactorial or related to high doses of steroids. Aggressive surgical management with semiopen treatment of peritonitis and frequent explorations has afforded excellent results.

Original languageEnglish (US)
Pages (from-to)594-598
Number of pages5
JournalThe American Journal of Surgery
Volume162
Issue number6
DOIs
StatePublished - Dec 1991

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Liver
Enteritis
Operative Surgical Procedures
Peritonitis
Cytomegalovirus
Laparotomy
Steroids
Pediatrics
Transplants
Weights and Measures
Transplant Recipients
Wounds and Injuries
Population
Therapeutics

ASJC Scopus subject areas

  • Surgery

Cite this

Syndrome of multiple bowel perforations in liver transplant recipients. / Marujo, Wagner C.; Stratta, Robert J.; Langnas, Alan Norman; Wood, R. Patrick; Markin, Rodney Smith; Shaw, Byers W.

In: The American Journal of Surgery, Vol. 162, No. 6, 12.1991, p. 594-598.

Research output: Contribution to journalArticle

Marujo, Wagner C. ; Stratta, Robert J. ; Langnas, Alan Norman ; Wood, R. Patrick ; Markin, Rodney Smith ; Shaw, Byers W. / Syndrome of multiple bowel perforations in liver transplant recipients. In: The American Journal of Surgery. 1991 ; Vol. 162, No. 6. pp. 594-598.
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