Laparoscopic Management of Small Bowel Obstruction in a Patient With Prior Kidney and Pancreas Transplantation.

Simultaneous pancreas-kidney (SPK) transplantation is a surgical treatment for patients with long-standing type 1 diabetes mellitus who consequently develop diabetic nephropathy and end-stage renal disease. Well-documented complications of pancreas transplant surgery include acute rejection, chronic rejection, pancreatitis, graft thrombosis, hemorrhage, anastomotic leakage, and intra-abdominal infection. However, small bowel obstruction (SBO), either through internal hernias or adhesive bands, can also occur. Our report details the case of a patient with a history of SPK transplantation 1.5 years earlier, presenting with peritonitis on examination and CT imaging concerning for a closed-loop SBO between the pancreatic allograft and small bowel mesentery. The patient successfully underwent laparoscopic management with laparoscopic small bowel resection and primary anastomosis.