ABSTRACT
Guillain-Barre syndrome is an acute immune-mediated demyelinating, polyneuropathy, which is usually provoked by a preceding infection. Guillain-Barre syndrome lies within the spectrum of disimmune neuropathies and usually occurs in immunocompromised patients because it is theoretically contradictory. Guillain-Barre syndrome in liver transplant recipients has been rarely reported. Here, we present a case of a patient who had undergone a deceased donor liver transplant and who developed symptoms of Guillain-Barre syndrome in the posttransplant period. We postulated that reactivation of varicella-zoster virus in our patient triggered the autoimmune-related peripheral neuropathy leading to Guillain-Barre syndrome; another etiology for this complication may be autoimmune hepatitis, as also shown in our patient.
Subject(s)
Autoimmune Diseases , Guillain-Barre Syndrome , Liver Transplantation , Autoimmune Diseases/complications , Guillain-Barre Syndrome/complications , Guillain-Barre Syndrome/etiology , Humans , Liver Transplantation/adverse effects , Living Donors , Treatment OutcomeABSTRACT
Ante-grade migration of a feeding jejunostomy tube is a rare occurrence. A 47-year-old lady with hypopharyngeal malignancy underwent surgical placement of jejunostomy tube. Eight months later, she came with disappearance of the tube from skin surface. Clinical examination revealed skin erosion and disappearance of previously placed tube. Abdominal radiograph showed radio.opaque tube in the abdomen in its entirety. The patient underwent reoperation to establish enteral feeding route and at the same time retrograde extraction of the tube (from proposed site for placement of jejunostomy tube). Use of proper fixation, placement of tube with dilated distal ends can potentially prevent these complications.
