Balloon enteroscopy for diagnosis and treatment of cytomegalovirus-induced small bowel gastrointestinal bleeding after whole-organ pancreas transplantation.

摘要

Whole-organ pancreas transplantation is being increasingly performed worldwide in selected patients with type I diabetes mellitus (1). The donor duodenum and pancreas are anastomosed to the jejunum to allow exocrine drainage using either loop in transit or by creation of a Roux-en-Y jejunal loop (2). In the latter situation, the donor duodenum and pancreas are relatively inaccessible using standard endoscopes. To our knowledge, we report the first case in which balloon enteroscopy was used to diagnose and treat small intestinal bleeding in a pancreas transplant patient with a Roux-en-Y anastomosis, in which the source of bleeding was located in the Roux limb in and around the duodeno-jejunal anastomosis.