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Author Notes:

Correspondence to: Antonio Guasch MD; Renal Division, Emory University School of Medicine, 1639 Pierce Drive, WMB Room 338, Atlanta, GA 30322; Ph: (404) 727-2525; Email: aguasch@emory.edu

The authors greatly appreciate Dr. Dominic C. Chow and Dr. Alisa M. Ching from Department of Medicine, University of Hawai‘i, John A. Burns School of Medicine for their great advice and critiques.

The authors report no conflict of interest.

Subjects:

Keywords:

  • autosomal dominant polycystic kidney disease (ADPKD)
  • diverticulitis
  • diverticulosis
  • kidney transplant

Atypical Presentation of Perforated Sigmoid Diverticulitis in a Kidney Transplant Recipient with Autosomal Dominant Polycystic Kidney Disease

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Journal Title:

Hawai'i Journal of Medicine & Public Health

Volume:

Volume 72, Number 7

Publisher:

, Pages 216-218

Type of Work:

Article | Post-print: After Peer Review

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.

Copyright information:

©2013 by University Clinical, Education & Research Associates (UCERA)

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