Late post liver transplant protein losing enteropathy: Rare complication of incisional hernia

Abstract

Development of oedema and hypoproteinaemia in a liver transplant recipient may be the first signs of graft dysfunction and should prompt a full assessment. We report the novel case of a patient who, years after liver transplantation developed a functional blind loop in an incisional hernia, which manifested as oedema and hypoproteinaemia secondary to protein losing enteropathy. After numerous investigations, the diagnosis was made by flurodeoxyglucose positron emmision tomography (FDG-PET) imaging. Surgical repair of the incisional hernia was followed several months later by resolution of the protein loss, and confirmed at a post operative FDG-PET scan at one year.

Keywords: Protein losing enteropathies; Bacterial overgrowth; Hypoproteinaemia; Incarcerated hernia; Liver transplantation.

Core tip: This report presents a rare case of protein losing enteropathy as a result of bacterial overgrowth in the blind loop of an incisional hernia following liver transplantation. Surgical repair of the incisional hernia in this case brought about resolution of protein loss.