REJECTION WITH DUODENAL RUPTURE AFTER SOLITARY PANCREAS TRANSPLANTATION - AN UNUSUAL CAUSE OF SEVERE HEMATURIA

A common urologic complication after pancreas transplantation with bla dder drainage is hematuria. However, hematuria is usually mild and sel f-limiting and raraly requires open surgical intervention. We report a n unusual case of refractory hematuria that began 17 days after solita ry pancreas transplantation due to severe rejection. The patient devel oped severe duodenal segment swelling with mucosal rupture that eventu ally required operative therapy. This case is illustrative of the diag nosis and management of gross hematuria after pancreas transplantation and demonstrates the limitations of cystoscopic techniques. This unus ual complication must be considered in the differential diagnosis of r efractory hematuria with pancreas allograft dysfunction and may repres ent a problem unique to solitary pancreas transplantation until better immunosuppressive strategies are available.