Severe gastroparesis causing splenic rupture: a unique, early complication after heart-lung transplantation

Several weeks or even months after heart-lung transplantation, gastroparesis-or delayed gastric emptying-commonly presents with cough, early satiety, and bloating. As it progresses, gastroparesis can cause substantial malnutrition and impair drug absorption. Gastroparesis after heart-lung transplant...

Full description

Saved in:
Bibliographic Details
Published in:Texas Heart Institute journal 2006, Vol.33 (4), p.508-511
Main Authors: Naik-Mathuria, Bindi, Jamous, Fady, Noon, George P, Loebe, Mattias, Seethamraju, Harish, Bag, Remzi
Format: Article
Language:English
Subjects:
Cardiomyopathies - surgery
Case Reports
Gastric Emptying
Gastroparesis - diagnostic imaging
Gastroparesis - etiology
Gastroparesis - surgery
Heart-Lung Transplantation
Humans
Male
Middle Aged
Postoperative Complications
Radiography
Sarcoidosis, Pulmonary - complications
Sarcoidosis, Pulmonary - surgery
Splenic Rupture - diagnostic imaging
Splenic Rupture - etiology
Splenic Rupture - surgery
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Several weeks or even months after heart-lung transplantation, gastroparesis-or delayed gastric emptying-commonly presents with cough, early satiety, and bloating. As it progresses, gastroparesis can cause substantial malnutrition and impair drug absorption. Gastroparesis after heart-lung transplantation can be attributed to bilateral vagus nerve injury, which probably occurs just above the level of the carina, where the recipient's trachea is resected. We report a highly unusual case wherein gastroparesis presented early after heart-lung transplantation and was managed conservatively. However, 19 days postoperatively, the patient developed acute abdominal pain and hypotension. Laparotomy revealed a massively dilated stomach and total avulsion of the splenic capsule with hemorrhage. The patient was fed via jejunostomy tubes until the gastroparesis resolved spontaneously. This case illustrates an important sequela of heart-lung transplantation. In order to decrease the morbidity from gastroparesis in these fragile patients, a drainage procedure should be considered as an adjunct to heart-lung transplantation.
ISSN:0730-2347