CASE REPORT   

Chirurgia 2020 April;33(2):107-10

DOI: 10.23736/S0394-9508.19.04971-4

Copyright © 2019 EDIZIONI MINERVA MEDICA

lingua: Inglese

Acute intestinal obstruction due to Mycobacterium avium complex enteritis in a heart transplant recipient

Jurij JANEŽ ^{1, 2} ✉, Armand D. ŠKAPIN ², Zdravko ŠTOR ¹

¹ Department of Abdominal Surgery, University Medical Center Ljubljana, Ljubljana, Slovenia; ² Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

We describe an unusual case of a male heart transplant recipient, who developed an acute small bowel obstruction caused by Mycobacterium avium complex (MAC) enteritis. The patient presented with a two-week history of persistent vomiting and mild weight loss. The abdominal contrast computed tomography (CT) prior to the emergency operation showed a small bowel obstruction and some enlarged lymph nodes in the vicinity. The emergency exploratory laparotomy confirmed the CT findings, thus we performed a resection of the stenotic small bowel segment and of the enlarged lymph nodes with a termino-terminal anastomosis. The pathohistological report revealed a chronic granulomatous inflammation of the small bowel and lymph nodes caused by MAC. To our knowledge, this infection presenting as an acute obstruction in an organ transplant recipient has not been previously reported.

KEY WORDS: Mycobacterium avium complex; Enteritis; Intestinal obstruction; Transplant recipients