L’addome acuto nel paziente trapiantato renale. Considerazioni epidemiologiche, diagnostiche e terapeutiche in DEA non dedicati

Costa, Gustavo and Tierno, Simone Maria and Stella, Franco and Tomassini, Federico and Venturini, Luigi and Frezza, Barbara and Fazzari, L. and Sinibaldi, V. and De Marco, C.M. and Cancrini, G. and Regine, Giovanni (2010) L’addome acuto nel paziente trapiantato renale. Considerazioni epidemiologiche, diagnostiche e terapeutiche in DEA non dedicati. Il giornale di chirurgia, 31 (11/12). pp. 497-501. ISSN 1971-145X

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Abstract

The incidence of gastrointestinal complications in renal transplant recipients is relatively high while about 10% is related to acute abdomen. Data concerning gastrointestinal (GI) complications were reported in literature mainly from referral center studies. A multicenter retrospectively survey was performed in Lazio, Italy, in order to evaluate the incidence of acute abdomen in renal transplant recipients observed to the emergency departments of not referral transplantation centers. Clinical and demographic findings regarding 14 patients who experienced acute abdomen between February 2005 and Dicember 2008 have been collected. The following data was investigated: etiology, diagnostic workup, duration of symptoms, elapsed time between admission and emergency operation if performed, morbility and mortality. The severity of disease at presentation was assessed by mean of the Acute Physiology and Chronic Health Evaluation score (APACHE II). Acute abdomen was due to pancreatitis in three patients (23.1%); to cholecystitis in three (23.1%); to acute diverticolitis with colon perforation in two patients (15.4%); to acute appendicitis in two (15.4%) and to intestinal obstruction in 2 patients (15.4%). Small bowel perforation was observed in two patients (15.4%) which one case, upon pathological examination, showed malignant lymphoma. The mean APACHE II score was 14.0±5.9. Ten patients (71.4%) were submitted to surgery. Overall mortality and morbidity were 35% and 42% respectively. Statistical analysis showed admission APACHE II score (p<0.01), duration of symptoms (p<0.05), and total time elapsed between the onset of symptoms and treatment (p<0.04) as factors significantly related to mortality.

Item Type:	Article
Uncontrolled Keywords:	Trapianto renale - Complicanze gastrointestinali - Strutture non dedicate - APACHE II - Ritardo dei sintomi
Subjects:	600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 617 Rami vari della medicina; Chirurgia
Depositing User:	Nadia Del Gobbo
Date Deposited:	22 Apr 2016 13:07
Last Modified:	22 Apr 2016 13:07
URI:	http://eprints.bice.rm.cnr.it/id/eprint/7224

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