Intestinal Obstruction in Autosomal Dominant Polycystic Kidney Disease.

Abstract

A 42-year-old womanwith autosomal dominant polycystic kidney disease (ADPKD) was admitted to our hospital on April 29, 1999, with complaints of abdominal pain. A diagnosis of intestinal obstruction wasreached on the basis of clinical findings and X-ray evidence. A computed tomography scan of the abdomenshowed massively enlarged kidneys, especially the right kidney, which seemed to compress the small intestine. The patient underwent percutaneous aspiration of the largest cysts on the surface of the right kidney. The symptoms, in this rare case of intestinal obstruction by an enlarged kidney in ADPKD, were alleviated the day after the aspiration procedure. (Internal Medicine 41: 441-444, 2002)

Percutaneous Nephrolithotomy in Autosomal Dominant Polycystic Kidney Disease: Is it Different from Percutaneous Nephrolithotomy in Normal Kidney?

“…The uremia, infection, fluid and electrolyte imbalance, cystic fluid, retroperitoneal blood and irrigation fluid extravasation all would have caused the paralytic ileus. In 2 patients the multiple cysts and retroperitoneal fluid were aspirated which led to recovery from ileus, similarly reported by others [20,21]. …”

Autosomal Dominant Polycystic Kidney Disease Showing Rupture of a Lateral Ventral Hernia Following Paralytic Ileus

“…In addition to colonodiverticulosis considered specific to ADPKD, intraabdominal pressure caused by enlarged kidneys has been known to lead to gastrointestinal complications such as abdominal wall hernia and ileus, as well as symptoms such as dysphagia, gastroesophageal reflux, early satiety and severe changes in bowel habit (4)(5)(6). On the basis of a questionnaire survey of 131 symptomatic ADPKD patients who underwent renal TAE in our institute, flank pain including abdominal distension and discomfort were shown in 88% of patients; upper digestive tract symptoms such as heartburn nausea, vomiting appetite loss and early satiety in 70%; intestinal symptoms such as severe constipation and odd bit- feces in 60%.…”

“…Colonic diverticulosis has been reported as a common manifestation of an extra-renal gastrointestinal tract complication (3). In addition, ileus has come to be recognized as one of the gastrointestinal complications of ADPKD (4). We report a case of an elderly male with ADPKD, in whom, following the occurrence of paralytic ileus, the swollen bowels broke through skin and spilled out outside of the skin.…”

Giant polycystic kidney and acute abdomen in chronic renal failure

“…Two case reports describe acute intestinal occlusion;[67] one described occlusion of the duodenum and the other of the small intestine. However, in the current case, the occlusion occurred in the terminal ileum.…”

“…In the literature, one case of intestinal obstruction was solved by puncture and suction of the kidney cysts,[6] and in another case, resection of part of the intestine was necessary due to ischemia. [4] The main complications of surgery in respect to other adjacent structures are splenic capsule and pleural lesions and injury to the inferior vena cava.…”