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Ríos A, Febrero B, Ramírez P, Rodriguez JM, Robles R, Bueno FS, Medina JG, Capel A, Parrilla P. Successful Embolization of a Cytomegalovirus-Related Duodenal Ulcer in a Kidney-Pancreas Transplant Recipient. Prog Transplant 2013; 23:217-9. [DOI: 10.7182/pit2013574] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
One of the complications that can occur in pancreas transplant is a massive intestinal hemorrhage, although such a hemorrhage is very rarely caused by ulcers due to cytomegalovirus infection. Treatment is fundamentally based on relaparatomy, although in some cases interventional radiology can be an efficient alternative because it allows the exact bleeding point to be located and therapeutic embolization to be performed. In this case, a man with diabetes type 1 who was given a simultaneous kidney-pancreas transplant had an ulcer due to cytomegalovirus infection develop in the duodenal graft (in the early postoperative period), causing a severe hemorrhage in the lower part of the gastrointestinal tract that was controlled via selective embolization of a branch of the pancreaticoduodenal artery.
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Affiliation(s)
- Antonio Ríos
- Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain (AR, BF, PR, JMR, RR, FSB, JGM, AC, PP), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd; AR, BF, PR, JMR, RR, FSB, PP)
| | - Beatriz Febrero
- Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain (AR, BF, PR, JMR, RR, FSB, JGM, AC, PP), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd; AR, BF, PR, JMR, RR, FSB, PP)
| | - Pablo Ramírez
- Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain (AR, BF, PR, JMR, RR, FSB, JGM, AC, PP), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd; AR, BF, PR, JMR, RR, FSB, PP)
| | - Jose Manuel Rodriguez
- Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain (AR, BF, PR, JMR, RR, FSB, JGM, AC, PP), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd; AR, BF, PR, JMR, RR, FSB, PP)
| | - Ricardo Robles
- Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain (AR, BF, PR, JMR, RR, FSB, JGM, AC, PP), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd; AR, BF, PR, JMR, RR, FSB, PP)
| | - Francisco Sánchez Bueno
- Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain (AR, BF, PR, JMR, RR, FSB, JGM, AC, PP), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd; AR, BF, PR, JMR, RR, FSB, PP)
| | - José García Medina
- Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain (AR, BF, PR, JMR, RR, FSB, JGM, AC, PP), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd; AR, BF, PR, JMR, RR, FSB, PP)
| | - Antonio Capel
- Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain (AR, BF, PR, JMR, RR, FSB, JGM, AC, PP), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd; AR, BF, PR, JMR, RR, FSB, PP)
| | - Pascual Parrilla
- Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain (AR, BF, PR, JMR, RR, FSB, JGM, AC, PP), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd; AR, BF, PR, JMR, RR, FSB, PP)
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Jahansouz C, Kumer SC, Ellenbogen M, Brayman KL. Evolution of β-Cell Replacement Therapy in Diabetes Mellitus: Pancreas Transplantation. Diabetes Technol Ther 2011; 13:395-418. [PMID: 21299398 DOI: 10.1089/dia.2010.0133] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Diabetes mellitus remains one of the leading causes of morbidity and mortality worldwide. According to the Centers for Disease Control and Prevention, approximately 23.6 million people in the United States are affected. Of these individuals, 5-10% have been diagnosed with type 1 diabetes mellitus (TIDM), an autoimmune disease. Although it often appears in childhood, T1DM may manifest at any age. The effects of T1DM can be devastating, as the disease often leads to significant secondary complications, morbidity, and decreased quality of life. Since the late 1960s, surgical treatment for diabetes mellitus has continued to evolve and has become a viable alternative to chronic insulin administration. In this review, the historical evolution, current status, graft efficacy, benefits, and complications of pancreas transplantation are explored.
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Affiliation(s)
- Cyrus Jahansouz
- University of Virginia School of Medicine, Charlottesville, Virginia, USA.
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