Laparoscopic treatment for renal paratransplant hernia: A case report. (May 2021)

• Record Type: Journal Article
• Authors: Igarashi, Yuto; Miyake, Katsunori; Yamano, Mizuki; Shimoyama, Rai; Kashiwagi, Hiroyuki; Kawachi, Jun
• Is Part Of: International journal of surgery case reports. Volume 82(2021)
• Publication Date: 2021-05
• Subjects: RPH renal paratransplant hernia -- CT computed tomography -- ADPKD autosomal dominant polycystic kidney disease; Renal paratransplant hernia -- Laparoscopic surgery -- Internal hernia -- Case report; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2021.105849
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: A kidney transplant recipient presented with abdominal pain and vomiting. Computed tomography confirmed a diagnosis of renal paratransplant hernia. Incarcerated small bowel was seen in the retroperitoneum via a peritoneal defect. Immunosuppressed patients can benefit from the laparoscopic treatment of RPH. Abstract: Introduction: There are limited reports regarding renal paratransplant hernia (RPH), which is a rare type of internal hernia. Herein, we report a case of successful laparoscopic treatment of RPH. Presentation of case: A kidney transplant recipient presented to our emergency department with a 6-h history of abdominal pain and vomiting. The patient had received a living-related donor kidney transplantation and native nephrectomy in our hospital last year. Computed tomography (CT) confirmed a diagnosis of RPH. We performed laparoscopic exploration, and the findings showed an incarcerated small bowel in the retroperitoneal space through a peritoneal defect. Short laparotomy was performed to resect the non-viable bowel. The peritoneal defect was opened adequately. The patient's postoperative course was uneventful, with no complications. Discussion: RPH is an uncommon variant of internal hernia, which is a rare surgical complication after kidney transplantation. Early diagnosis and treatment are important once RPH develops. Due to immunosuppression in kidney transplant recipients, typical signs of peritonitis were not observed. This event can be critical to the patient. Laparoscopic surgery has recently become a treatment option for small bowel obstructions. We believe that this surgical procedure is useful for patients with RPH. Conclusion: We report a case of RPH treated laparoscopically. This approach can be a treatment of choice for RPH.