Severe gastroparesis causing splenic rupture: A unique, early complication after heart-lung transplantation

Bindi Naik-Mathuria, Fady Jamous, George P. Noon, Mattias Loebe, Harish Seethamraju, Remzi Bag

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Several weeks or even months after heart-lung transplantation, gastroparesis - or delayed gastric emptying - commonly presents with cough, early satiety, and bloating. As it progresses, gastroparesis can cause substantial malnutrition and impair drug absorption. Gastroparesis after heart-lung transplantation can be attributed to bilateral vagus nerve injury, which probably occurs just above the level of the carina, where the recipient's trachea is resected. We report a highly unusual case wherein gastroparesis presented early after heart-lung transplantation and was managed conservatively. However, 19 days postoperatively, the patient developed acute abdominal pain and hypotension. Laparotomy revealed a massively dilated stomach and total avulsion of the splenic capsule with hemorrhage. The patient was fed via jejunostomy tubes until the gastroparesis resolved spontaneously. This case illustrates an important sequela of heart-lung transplantation. In order to decrease the morbidity from gastroparesis in these fragile patients, a drainage procedure should be considered as an adjunct to heart-lung transplantation.

Original languageEnglish (US)
Pages (from-to)508-511
Number of pages4
JournalTexas Heart Institute Journal
Volume33
Issue number4
StatePublished - Dec 1 2006

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Keywords

  • Gastroparesis
  • Heart-lung transplantation/adverse effects
  • Hemorrhage
  • Postoperative complications
  • Splenic rupture
  • Vagus nerve/injuries

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Naik-Mathuria, B., Jamous, F., Noon, G. P., Loebe, M., Seethamraju, H., & Bag, R. (2006). Severe gastroparesis causing splenic rupture: A unique, early complication after heart-lung transplantation. Texas Heart Institute Journal, 33(4), 508-511.