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Órgano Oficial del Instituto Nacional de Pediatría
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2016, Number 6

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Acta Pediatr Mex 2016; 37 (6)

Ascites after pediatric renal transplant. Case report

Zaltzman-Girshevich S,Sánchez-García C,Suárez-Barajas EM, Corcuera-Delgado CT
Full text How to cite this article

Language: Spanish
References: 12
Page: 328-332
PDF size: 1067.05 Kb.


Key words:

chylous ascites, collapsing glomerulonephritis, nephrocalcinosis, kidney transplant, case report.

ABSTRACT

The presence of ascites after a renal transplant is an uncommon entity generally caused by complications of the surgical technique. We present a 5 year-old male with diagnosis of chronic glomerulonephritis; who received a kidney transplant of a related live donor, with adequate function of the allograft during the first hours after transplant, developing ascites 72 hours after surgery, with a serum-ascites albumin gradient of 0.92 g/dL. Because of this a surgical intervention was necessary; there was ascites in great amount in the peritoneal cavity and infiltration of liquid in between the surface of the native kidney and its capsule; nephrectomy of this kidney was done. In the histopathological exam severe dilatation of the lymphatic vessels was observed. The patient evolution after the surgery was satisfactory. Chylous ascites is due to the drain of lymph into the peritoneal cavity. In the literature we found some cases of ascites of lymph origin after kidney transplant. According to the findings described; we considered that the ascites was due to lymph transudate from the capsule of the native kidney secondary to obstruction of the lymph vessels due to excessive aortic manipulation during renal transplant surgery. In pediatric patients that have undergone an intraperitoneal renal transplant and develop ascites, the lymphatic origin of this should be consider.


REFERENCES

  1. Humar A, Matas AJ. Surgical complications after kidney transplantation. Semin Dial. 2005;18(6):505-10.

  2. Markov M, Van Thiel DH, Nadir A. Ascites and kidney transplantation: case report and critical appraisal of the literature. Dig Dis Sci. 2007;52(12):3383-8.

  3. Saif MW, Siddiqui IA, Sohail MA. Management of ascites due to gastrointestinal malignancy. Ann Saudi Med. 2009;29(5):369-367.

  4. Al-Busafi SA, Ghali P, Deschênes M, Wong P. Chylous ascites: Evaluation and Management. ISRN Hepatology. 2014. DOI 10.1155/2014/240473.

  5. Cardenas A, Chopra S. Chylous ascites. Am J Gastroenterol. 2002;97(8):1896-900.

  6. Clark WF, Sullivan SN, Lindsay RM, Wang YL, Turnbull ID, Linton AL. Ascites Secondary to Transudation from A Renal Cadaveric Transplant. JAMA. 1976;235(6):635.

  7. Kulkarni S, Burns A, Al-Akraa M. Severe ascites following renal transplant biopsy caused by a rupture of a subcapsular lymphocele: treated successfully by retroperitonealization. Nephrol Dial Transplant. 2004;19(4):1022-3.

  8. Liu WC, Kuo MC, Wu WJ, Hwang SJ, Chen HC. Chylous ascites after renal transplantation – a case report. Nephrol Dial Transplant. 2006;21(11):3336-7.

  9. Itoh K, Tanda K, Kato C, Kanagawa K, Seki T. Intraperitoneal leakage of technectium-99m-DTPA following renal transplantation: a sign of chylous ascites. J Nucl Med. 1994;35(1):93-4.

  10. Riar S, Warshaw B, Amaral S. Chylous ascites complicating pediatric renal transplantation. Pediatr Nephrol. 2012;27(8):1397-9.

  11. Heptinstall RH. Pathology of the kidney. 2nd ed. Boston: Little, Brown; 1974. 539 p.

  12. Cohen HL, Kassner EG, Haller JO. Nephrocalcinosis in chronic glomerulonephritis: report of the youngest patient. Urol Radiol. 1981;2(1):51-2.




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Acta Pediatr Mex. 2016;37