Bowel Strangulation During Renal Transplant Procedure

Case Overview

The case involves a patient who experienced a nicked peritoneum during a renal transplant procedure. The nicked peritoneum was mentioned in the medical record, but the defending physician denied that he had any knowledge of its occurrence. He claimed he never visualized the lesion during the operation and thus it was not repaired during that time. Three days after the procedure, the patient developed an infection and, five days later, the patient became septic. The patient went back into surgery with the original surgeon and the colon was found to be necrotic. The record stated that there is a large perforation in the peritoneum and that the colon was strangulated. Furthermore, it was reported that, after the procedure, the patient experienced swelling in his right testicle. The testicle was removed as it was thought to be cancerous, but it was later revealed that this may have been related to the bowel strangulation.

Questions to the General Surgery expert and their responses

Was this a breach of the standard of care?

The part of this case that is worrisome to me is the fact that the physicians on this case jumped to conclusions. Then they removed this man's testicle without confirming the presence of malignancy. That would be beneath the standard of care, in my opinion.

About the expert

This expert is a board certified General surgeon with additional fellowship training in minimally invasive surgical techniques. He was trained at the University of California Davis School of Medicine for residency and at Johns Hopkins for fellowship. He is the Director of a surgical hernia center at a prestigious medical university in Maryland and treats a significant amount of cancer patients.