Roux limb volvulus after pancreas transplantation: an unusual cause of pancreatic graft loss

Clin Transplant. 2009 Nov-Dec;23(6):807-11. doi: 10.1111/j.1399-0012.2008.00945.x. Epub 2009 Jan 10.


Pancreas transplantation with enteric drainage avoids the long-term urological complications of bladder drainage. Increasing use of this technique raises the possibility of complications from the enteric reconstruction. This report describes a patient five yr after left-sided pancreas transplant with Roux-en-Y enteric drainage, presenting with abdominal pain, leukocytosis and radiological evidence of bowel obstruction. Exploration revealed a volvulus of the Roux limb as it passed through the mesocolon, with necrosis of the allograft duodenum and marked congestion of the pancreas. This is the first report of pancreas graft loss due to this entity, which should be recognized as an unusual cause of abdominal pain after pancreas transplantation. Potential bowel complications related to the sigmoid mesentery in left-sided pancreas transplantation are additional reasons for right-sided placement of the pancreas allograft.

Publication types

  • Case Reports

MeSH terms

  • Anastomosis, Roux-en-Y / adverse effects
  • Diabetes Mellitus, Type 1 / surgery
  • Follow-Up Studies
  • Graft Rejection / diagnosis
  • Graft Rejection / etiology*
  • Graft Rejection / surgery
  • Humans
  • Intestinal Volvulus / complications*
  • Intestinal Volvulus / diagnosis
  • Intestinal Volvulus / surgery
  • Male
  • Middle Aged
  • Pancreas Transplantation / adverse effects*
  • Pancreatectomy / methods
  • Postoperative Complications
  • Time Factors
  • Tomography, X-Ray Computed