Evidence map›Paper›PMID 40761222›Full record

ArticleAME case reports2025

Multifocal bowel perforation from angioinvasive aspergillosis after bilateral lung transplantation: a case report and review of the literature.

Kacie Kerlee, Jasmina Ehab, Jeremy Watson, Patrick Weill, Raghav Chandra, Suresh Keshavamurthy, Ankeeta Mehta, Thomas H Shoultz

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PubMed Full text at PMC Publisher
In one paragraph

Article in AME case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Kacie KerleeDivision of Burns, Trauma, Acute and Critical Care Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Jasmina EhabDivision of Burns, Trauma, Acute and Critical Care Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Jeremy WatsonDivision of Burns, Trauma, Acute and Critical Care Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Patrick WeillDivision of Pulmonology and Critical Care Medicine, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Raghav ChandraDivision of Burns, Trauma, Acute and Critical Care Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Suresh KeshavamurthyDepartment of Cardiovascular and Thoracic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Ankeeta MehtaDivision of Burns, Trauma, Acute and Critical Care Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Thomas H ShoultzDivision of Burns, Trauma, Acute and Critical Care Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Lung transplant recipients on immunosuppression are at increased risk for aggressive opportunistic infections, including invasive aspergillosis (IA). Distal septic embolization from angio-IA with involvement of the small and large bowel is extremely uncommon, and clinical manifestations of bowel ischemia and perforation may be masked due to immunosuppression. Case Description: We present herein the first reported case of peritonitis secondary to jejunal and cecal perforation secondary to angio-IA after lung transplantation (LT) in a 62-year-old male. The patient was admitted to the hospital for acute cellular rejection requiring high-dose immunosuppression. His course was complicated by respiratory failure secondary to IA, with resulting multiorgan system dysfunction during which time peritonitis was noted on examination and cross-sectional imaging demonstrated pneumatosis, portal venous gas, and pneumoperitoneum. The patient required emergent surgical intervention and underwent an exploratory laparotomy, jejunal resection, right hemicolectomy, and end ileostomy with colonic mucus fistula. Final pathologic analysis of resected specimens demonstrated angio-IA in both the jejunal and cecal segments with associated transmural ischemic necrosis. Conclusions: Bowel perforation secondary to angio-IA is a very rare but serious complication after LT that is associated with high morbidity and mortality. Evaluation requires a high index of suspicion in the setting of immunosuppression and often concomitant extraintestinal pathologies. Early, aggressive surgical intervention is necessary.

Indexed as

Aspergillosisbowel perforationcase reportlung transplantation (LT)pneumatosis

Identifiers

PMID40761222
PMCPMC12319623

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.