Inguinal hernia containing bladder and ureteroneocystostomy: a rare cause for acute renal graft dysfunction

BMJ Case Reports
Hugo CoelhoPaulo Temido

Abstract

A 77-year-old man presented with acute graft dysfunction 25 years after a renal transplant in the left iliac fossa. He also had an asymptomatic left inguinal hernia. Renal ultrasound showed a significant pyelocalicial dilation of the kidney graft and the patient was submitted to a percutaneous nephrostomy. An antegrade nephrostogram was performed, which showed a dilated ureter and the bladder included in the left inguinal hernia that caused the obstructive uropathy. Concomitant retrograde cystography also showed a significant portion of the bladder in the hernia sac. The patient was submitted to inguinal hernia repair, which resolved the obstruction. We present a rare and potentially curable cause of obstructive uropathy in a transplant recipient; it is possible to revert graft dysfunction and prevent graft loss if the condition is recognised early.

Citations

Oct 28, 2016·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·T du ToitD Kahn
Jan 27, 2018·Canadian Journal of Kidney Health and Disease·Ann BugejaSohrab N Ali
Jan 21, 2019·BMJ Case Reports·Douglas J CassidyVicki Sein

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