Diagnosis and treatment of acute appendicitis after orthotopic liver transplant in adults

Linwei Wu, Jianwei Zhang, Zhiyong Guo, Qiang Tai, Xiaoshun He, Weiqiang Ju, Dongping Wang, Xiaofeng Zhu

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Objectives: The incidence of acute appendicitis after orthotopic liver transplant is low but difficult to differentiate from other posttransplant complications. We sought to summarize the clinical characteristics, diagnosis, and treatment of acute appendicitis during the early posttransplant stage. Materials and Methods: Data from 4 liver transplant recipients with acute appendicitis immediately after transplant and 4 patients with misdiagnosed appendicitis, between January 2000 and December 2007, were studied retrospectively. Results: The incidence of acute appendicitis immediately after orthotopic liver transplant was 0.49%. Four patients had right lower quadrant abdominal pain with fixed tenderness, rebound tenderness, and fever on the eighth, ninth, 11th, and 13th days after surgery. White blood cells counts were elevated in all patients. Appendectomies were performed on day 1 or 2 after the onset of symptoms. No appendicular perforations were found. All patients recovered well. After an exploratory laparotomy, the 4 patients originally misdiagnosed with appendicitis were correctly diagnosed with a duodenal diverticulum perforation (1 patient), a jejunum perforation (1 patient), and bile leakage (2 patients). Two of these patients died despite aggressive treatment. Conclusions: The incidence of acute appendicitis immediately after orthotopic liver transplant is low and should be differentiated from other surgical complications, such as gastrointestinal perforation and bile leakage. Appendectomy is recommended in these patients as early as possible.

Original languageEnglish (US)
Pages (from-to)113-117
Number of pages5
JournalExperimental and Clinical Transplantation
Volume9
Issue number2
StatePublished - Apr 1 2011

Keywords

  • Appendectomy
  • Complication
  • Inflammation
  • Prognosis
  • Transplantation

ASJC Scopus subject areas

  • Transplantation

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