Unusual cause of ureteral obstruction in transplant kidney

Furtado, Claudia D.; Sirlin, Claude B.; Precht, Andrew F.; Casola, G

doi:10.1007/s00261-005-0044-y

Cited by 29 publications

(19 citation statements)

References 19 publications

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“…In both cases, hydronephrosis was the only major finding, and the diagnosis was made by other methods (CT and antegrade pyelography). 6,9 In our case, CT also was performed, but only to confirm the findings shown by sonography and to allow a clear picture for surgery planning by the urology team.…”

Section: Discussionmentioning

confidence: 99%

“…4 The case reported here had herniation and incarceration of the ureter in the inguinal canal, a rare cause of urinary tract obstruction in transplants, with few reports in the literature. [5][6][7][8][9] Accurate diagnosis is of the utmost importance because of potential development of obstructive nephropathy or a ureteral lesion during surgery for correction of the hernia. 10 Inguinal hernias of the ureter have been widely reported in the medical literature.…”

Section: Discussionmentioning

confidence: 99%

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Sonographic Diagnosis of a Ureteral Inguinal Hernia in a Renal Transplant

Otani

Jayanthi

Chiarantano

et al. 2008

Journal of Ultrasound in Medicine

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omplications related to renal transplants have been widely reported in the literature. The most common complications include acute tubular necrosis, rejection, perirenal fluid collections, vascular complications, and urinary tract obstruction, which are promptly identified by imaging studies. Here we report a case of a patient with a rare cause of obstruction: a ureteral inguinal hernia. This is the sixth report of this condition, and, to our knowledge, no previous case has been reported in which sonography played an important role in promptly identifying the underlying condition and allowing additional less hazardous studies, therefore aiding case management.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Sonographic Diagnosis of a Ureteral Inguinal Hernia in a Renal Transplant

Otani

Jayanthi

Chiarantano

et al. 2008

Journal of Ultrasound in Medicine

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“…The definitive treatment is operative herniorrhaphy usually without the need for ureteral re-implantation (14)(15)(16)(17)22). In a report of inguinal herniation from a pediatric en bloc donor, transection and reimplantation of an extremely redundant ureter was necessary (15).…”

Section: Case Presentationmentioning

confidence: 98%

A Rare Case of Obstructive Uropathy in Renal Transplantation: Ipsilateral Indirect Inguinal Herniation of a Transplant Ureter

et al. 2009

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“…4–6 In most cases, the clinical course of inguinal hernia repair is uneventful, but inguinal herniation of a transplanted ureter may, in rare instances, cause obstructive uropathy with graft dysfunction in kidney transplant recipients. 7–19 …”

Section: Introductionmentioning

confidence: 99%

First Case Report of Acute Renal Failure After Mesh-Plug Inguinal Hernia Repair in a Kidney Transplant Recipient

Veroux¹,

Ardita

Zerbo³

et al. 2016

Medicine

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Acute renal failure due to ureter compression after a mesh-plug inguinal repair in a kidney transplant recipient has not been previously reported to our knowledge. A 62-year-old man, who successfully underwent kidney transplantation from a deceased donor 6 years earlier, was admitted for elective repair of a direct inguinal hernia. The patient underwent an open mesh-plug repair of the inguinal hernia with placement of a plug in the preperitoneal space. We did not observe the transplanted ureter and bladder during dissection of the inguinal canal. Immediately after surgery, the patient became anuric, and a graft sonography demonstrated massive hydronephrosis. The serum creatinine level increased rapidly, and the patient underwent an emergency reoperation 8 hours later. During surgery, we did not identify the ureter but, immediately after plug removal, urine output increased progressively. We completed the hernia repair using the standard technique, without plug interposition, and the postoperative course was uneventful with complete resolution of graft dysfunction 3 days later.Furthermore, we reviewed the clinical features of complications related to inguinal hernia surgery. An increased risk of urological complications was reported recently in patients with a previous prosthetic hernia repair undergoing kidney transplantation, mainly due to the mesh adhesion to surrounding structures, making the extraperitoneal dissection during the transplant surgery very challenging. Moreover, older male kidney transplant recipients undergoing an inguinal hernia repair may be at higher risk of graft dysfunction due to inguinal herniation of a transplanted ureter.Mesh-plug inguinal hernia repair is a safe surgical technique, but this unique case suggests that kidney transplant recipients with inguinal hernia may be at higher risk of serious urological complications. Surgeons must be aware of the graft and ureter position before proceeding with hernia repair. A prompt diagnosis with graft sonography and abdominal computed tomography scan and emergency surgery may avoid the need for nephrostomy and may resolve graft dysfunction more rapidly.

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Unusual cause of ureteral obstruction in transplant kidney

Cited by 29 publications

References 19 publications

Sonographic Diagnosis of a Ureteral Inguinal Hernia in a Renal Transplant

Sonographic Diagnosis of a Ureteral Inguinal Hernia in a Renal Transplant

A Rare Case of Obstructive Uropathy in Renal Transplantation: Ipsilateral Indirect Inguinal Herniation of a Transplant Ureter

First Case Report of Acute Renal Failure After Mesh-Plug Inguinal Hernia Repair in a Kidney Transplant Recipient

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