Small bowel obstruction caused by a bezoar following an adult simultaneous liver-kidney transplantation: A case report

Abstract

BACKGROUND Small bowel obstructions (SBOs) are common following a large intra-abdominal operation; however, SBOs caused by bezoars are unreported in patients following liver-kidney transplantation procedures, particularly in adults. CASE SUMMARY A 65-year-old Caucasian female presented with nausea and nonbilious emesis during her postoperative course following a simultaneous liver-kidney transplantation. She developed worsening nausea and vomiting with significant abdominal distension and obstipation. Computed tomography imaging showed a marked abnormal dilation of multiple small bowel loops with a distinct transition point that was suggestive of a small bowel obstruction. An exploratory laparotomy revealed a foreign body in the intestinal track approximately 30 cm from the ileocecal valve. The foreign body was extracted and identified as a bezoar with hair follicles and old digestive contents. Following the operation, the patient demonstrated rapid clinical improvement with resolution of nausea, emesis, and progress in bowel motility. CONCLUSION SBOs caused by bezoars can occur immediately following a liver-kidney transplantation and should not be discounted as a diagnosis.

Biliary Drainage Impairment After Liver Transplantation As a Result of Adhesive Small-Bowel Obstruction

“…Small bowel obstructions are a common morbidity associated with abdominal surgery. [1] Also, biliary complications are a common cause of morbidity following liver transplantation, and approximately 15-20% of all allograft recipients develop a biliary complication within 2 years. [2] Treatment modalities include both operative and nonop-erative management.…”