Ischemic colitis with small-vessel occlusion,simultaneous total colectomy and liver transplantation:A case report  

作　　者：Leonardo Yuri Kasputis Zanini Fabiana Roberto Lima Michel Ribeiro Fernandes Paola Sofia Espinoza Alvarez Marcello de Souza Silva Antônio Paulo Ramos Martins Filho Tomazo Antonio Prince Franzini Lucas Souto Nacif 

机构地区：[1]Department of Surgery,Federal University of São Paulo,São Paulo 04023-062,Brazil [2]Department of Liver and Gastrointestinal Transplant,Hospital 9 de Julho,São Paulo 01409-002,Brazil [3]Department of Pathology,University of São Paulo School of Medicine,São Paulo 05403-900,Brazil [4]Department of Surgical Pathology,Hospital 9 de Julho,São Paulo 01409-002,Brazil [5]Department of Gastrointestinal Endoscopy Unit,Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo,São Paulo 05403-010,Brazil [6]Department of Endoscopy,Hospital 9 de Julho,São Paulo 01409-002,Brazil

出　　处：《World Journal of Transplantation》2025年第2期337-343,共7页世界移植杂志(英文)

摘　　要：BACKGROUND The colon is the hollow viscera that proportionally has the lowest vascular supply and is more predisposed to ischemic colitis.In the context of end-stage liver disease,various components may explain this group's greater predisposition to colonic ischemic events.Furthermore,portal hypertension generates a process of coagulopathy,impairing local vascularization.This case report describes a case of ischemic colitis with small-vessel occlusion found during liver transplantation in a patient with decompensated end-stage liver disease.CASE SUMMARY A 64-year-old man with liver cirrhosis due to non-alcoholic steatohepatitis and hepatocellular carcinoma.The patient underwent liver transplantation due to hepatic decompensation.The donor was a 53-year-old man who had died of a hemorrhagic stroke.Cavitary examination revealed diffuse ischemic colitis with significant distention and necrosis.Due to the condition of the colon,a subtotal colectomy was performed.Liver transplantation with warm ischemia time of 35 minutes,cold ischemia of 6 hours 30 minutes and total ischemia time of 7 hours 5 minutes.The patient improved clinically with oral tract function and physiotherapy,but unfortunately,he developed a bloodstream infection,a new septic shock and died six months after surgery.CONCLUSION Simultaneous total colectomy and orthotopic liver transplantation represent a rare situation.Ischemic events have a high mortality rate in the general population and are particularly important in cirrhotic patients.

关 键 词：Ischemic colitis Liver transplantation End-stage liver disease Acute-on-chronic liver failure Case report 

分 类 号：R57[医药卫生—消化系统]