Igarashi Yuto, Miyake Katsunori, Yamano Mizuki, Shimoyama Rai, Kashiwagi Hiroyuki, Kawachi Jun
Department of Surgery, Shonan Kamakura General Hospital, Kanagawa, Japan; Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, Kanagawa, Japan.
Department of Surgery, Shonan Kamakura General Hospital, Kanagawa, Japan; Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, Kanagawa, Japan.
Int J Surg Case Rep. 2021 May;82:105849. doi: 10.1016/j.ijscr.2021.105849. Epub 2021 Apr 1.
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.
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.
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.
We report a case of RPH treated laparoscopically. This approach can be a treatment of choice for RPH.
关于肾移植旁疝（RPH）的报道有限，这是一种罕见的内疝类型。在此，我们报告一例成功通过腹腔镜治疗RPH的病例。
一名肾移植受者因腹痛和呕吐6小时就诊于我院急诊科。该患者去年在我院接受了亲属活体供肾移植及自体肾切除术。计算机断层扫描（CT）确诊为RPH。我们进行了腹腔镜探查，结果显示通过腹膜缺损，一段嵌顿的小肠位于腹膜后间隙。进行了短切口剖腹术以切除无活力的肠段。充分打开腹膜缺损处。患者术后恢复顺利，无并发症。
RPH是内疝的一种不常见变异，是肾移植后罕见的手术并发症。一旦RPH发生，早期诊断和治疗很重要。由于肾移植受者存在免疫抑制，未观察到典型的腹膜炎体征。这一情况对患者可能至关重要。腹腔镜手术近来已成为小肠梗阻的一种治疗选择。我们认为这种手术方法对RPH患者有用。
我们报告了一例通过腹腔镜治疗的RPH病例。这种方法可以成为RPH的一种治疗选择。
