Anastomotic Leak Of Pancreatic Transplant Demonstrated By Radionuclide Cystography

A 37-year-old woman presented 2 months after combined pancreatic-renal allograft transplantation for diabetes mellitus, with right iliac fossa pain of several days' duration. Abdominal ultrasound examination revealed a moderate amount of free fluid particularly in the paracolic, perihepatic, and perisplenic regions suggesting an anastomotic leak between the duodenal stump of the pancreatic graft and bladder. A direct (catheter) radionuclide cystogram demonstrated communication between urinary bladder and peritoneal cavity, The anastomotic leak at the level of the transplanted duodenum was confirmed surgically and repaired.