Duodenal graft perforation after 9 years from simultaneous pancreas-kidney transplantation

Transplantation is a natural replacement therapy for kidney and pancreatic failures. Transplant complications should be treated in hub centers; however, it is also true that some acute complications must be treated by emergency surgeons. Simultaneous pancreas-kidney transplantation (SPK) is a standardized surgical procedure; however, it is associated with complications, some of which can lead to graft loss. We report the case of a 41-year-old woman with duodenal graft perforation nine years after undergoing SPK. The patient was referred with an acute abdomen secondary to small-bowel obstruction. The finding of an adhesive band near the cecal valve during surgery led us to understand the cause of this complication. This case report demonstrates the need for rapid treatment of the most dangerous complications in transplant patients. The intestinal obstruction and duodenal graft perforation were treated in the emergency surgery department.