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Abstract
Background:
Appendicitis is a common surgical disease. There are many problems for the early diagnosis of acute appendicitis in kidney transplant patients; differential diagnosis for acute rejection, limitation in imaging study, problems of immunosuppressant and non-characteristic symptoms.
Methods:
We reviewed medical records and transplant database of 2,947 renal transplant patients between April, 1979 and September, 2009 retrospectively. Patient's characteristics, diagnostic methods for appendicitis and operative/postoperative progresses were analyzed.
Results:
Of the 2,947 renal transplant patients, there were 15 (0.51%, 13 males and 2 females) acute appendicitis patients. Mean age at the diagnosis of appendicitis was 37.2±10.1 years. Fourteen (93.3%) patients suffered from prodromal symptom, such as abdominal pain, direct or rebound tenderness, nausea and vomiting. There were 12 (80%) patients with leukocytosis (WBC count ＞10,000/μ L). Computed tomography scans were performed in 5 (33.4%) patients for diagnosis. Laparoscopic appendectomies were applied for 8 (53.4%) patients. In pathologic diagnosis, 2 cases were reported as 'non pathologic diagnosis' complications occurred in 2 patients as remnant appendicitis and pancreatitis. However, there was no patient with mortality and renal failure during the hospitalization.
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REFERENCES
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Table 1.
Incidence of acute appendicitis by demographics
| Demographics | No. | No. of acute appendicitis | Incidence (%) | P-value | |
|---|---|---|---|---|---|
| Gender | Male | 1,969 | 13 | 0.66 | 0.108 |
| Female | 978 | 2 | 0.20 | ||
| Age at transplantation | ＜20 | 161 | 1 | 0.62 | |
| 20∼29 | 592 | 7 (1)∗ | 1.18 | ||
| 30∼39 | 894 | 3 | 0.34 | 0.259 | |
| 40∼49 | 764 | 2 (1)∗ | 0.26 | ||
| ≥50 | 536 | 2 | 0.37 | ||
Table 2.
Clinical characteristics of acute appendicitis after kidney transplantation
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