Bugeja Ann, Clark Edward G, Sood Manish M, Ali Sohrab N
Division of Nephrology, Department of Medicine, The Ottawa Hospital, University of Ottawa, Ontario, Canada.
Division of Urology, Department of Surgery, The Ottawa Hospital, University of Ottawa, Ontario, Canada.
Can J Kidney Health Dis. 2018 Jan 17;5:2054358117753620. doi: 10.1177/2054358117753620. eCollection 2018.
Kidney allograft dysfunction is common and often reversible but can lead to allograft loss if not promptly evaluated. Transplant ureteral obstruction in an inguinal hernia is a rare cause of allograft dysfunction, but early recognition may prevent allograft loss.
We present a case of a man with acute kidney allograft dysfunction who received a deceased donor kidney transplant 6 years earlier for end-stage kidney disease secondary to polycystic kidney disease. Abdominal ultrasounds revealed hydronephrosis without full visualization of the transplant ureter. Abdominal computed tomography revealed moderate hydronephrosis of the transplant kidney due to obstructed herniation of the transplant ureter in a right inguinal hernia. A stent was inserted into the transplant ureter to prevent further allograft dysfunction and facilitate hernia repair.
Transplant ureteral obstruction is a rare cause of acute kidney allograft dysfunction, and its detection can be challenging. The recognition of transplant ureteral obstruction is vital to timely management for preventing allograft loss.
肾移植功能障碍很常见，且通常是可逆的，但如果不及时评估，可能导致移植肾丢失。腹股沟疝中的移植输尿管梗阻是移植肾功能障碍的罕见原因，但早期识别可预防移植肾丢失。
我们报告一例急性肾移植功能障碍患者，该患者6年前因多囊肾病继发终末期肾病接受了尸体供肾移植。腹部超声显示肾盂积水，但未完全显示移植输尿管。腹部计算机断层扫描显示，由于移植输尿管在右侧腹股沟疝中梗阻性疝出，移植肾中度肾盂积水。在移植输尿管中置入支架以防止移植肾功能进一步恶化，并便于疝修补。
移植输尿管梗阻是急性肾移植功能障碍的罕见原因，其检测可能具有挑战性。认识到移植输尿管梗阻对于预防移植肾丢失的及时管理至关重要。
