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Case report
Small bowel perforation secondary to CMV-positive terminal ileitis postrenal transplant
  1. Kosuke Kato and
  2. Michelle Cooper
  1. Department of General Surgery, Gold Coast University Hospital, Southport, Queensland, Australia
  1. Correspondence to Dr Kosuke Kato; kosuke.kato.kk{at}


Cytomegalovirus (CMV) infection of the gastrointestinal tract is common in immunosuppressed patients; however, small bowel perforation from tissue-invasive CMV disease after many years of immunosuppressive therapy is a rare complication requiring timely medical and surgical intervention. We report a case of a postrenal transplant patient who presented to the emergency department with severe lower abdominal pain with CT of the abdomen/pelvis revealing a small bowel perforation. He underwent an emergent laparoscopic right hemicolectomy, and his histopathology of the terminal ileum was positive for CMV disease. He was successfully treated with intravenous ganciclovir postoperatively. We discuss the pathophysiology, histopathological features and treatment of CMV infection.

  • general surgery
  • renal transplantation
  • infection (gastroenterology)

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  • Contributors This case report was written by KK. Editing and supervision was provided by MC.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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