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Renal transplant

Case contributed by Henry Knipe
Diagnosis certain

Presentation

Bowels not open post op.

Patient Data

Age: 40 years
Gender: Male
x-ray

Tenckhoff catheter projects over the pelvis. Left iliac fossa double J stent and surgical clips in keeping with renal transplant. 

Prominent the non-dilated loops of small bowel with multiple non-specific air fluid levels. Gas is still present in the rectum. Features favor an ileus over a mechanical bowel obstruction.

Changes of avascular necrosis are noted in both femoral heads.

Case Discussion

All the clues are here on the x-ray to:

  • work out the cause of the patient's symptoms: paralytic ileus
  • underlying cause: recent left iliac fossa renal transplant
  • assess for complications: femoral head avascular necrosis (although this is not related to the current transplant but the underlying cause for renal failure / previous failed renal transplant; the cause in this patient is not known)

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