Roux‐en‐Y enterolith leading to obstruction and ischemic necrosis after pediatric orthotopic liver transplantation |
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Authors: | Ralph C. Quillin III Advaith Bongu Vania Kasper Jennifer M. Vittorio Mercedes Martinez Steven J. Lobritto Adam D. Griesemer James V. Guarrera |
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Affiliation: | 1. Department of Surgery, Center for Liver Disease and Transplantation, Columbia University Medical Center, New York, NY, USA;2. Department of Surgery, Division of Liver Transplant and HPB Surgery, Rutgers University, Newark, NJ, USA |
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Abstract: | Biliary complications are a common cause of morbidity after liver transplantation, with biliary stone formation being a known occurrence generally upstream of a stricture. A 12‐year‐old boy, who underwent an orthotopic liver transplantation at 11 months of age for biliary atresia, presented acutely with fever and abdominal pain. Cross‐sectional imaging revealed Roux‐en‐Y limb dilatation and thickening. He was explored and was found to have an ischemic Roux limb secondary to an obstructing enterolith. A segmental bowel resection and revision of his hepaticojejunostomy was performed. While rare, biliary enteroliths may present as either a bowel obstruction or cholangitis and should be considered in the differential diagnosis of a patient following biliary reconstruction. Additionally, anatomic etiologies should be considered and potentially surgically corrected. |
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Keywords: | biliary reconstruction enterolith liver transplant |
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