Renal Paratransplant Hernia: A Rare Complication of Renal Transplantation

Renal paratransplant hernia (RPH) is a rare type of internal hernia. There may be a delay in diagnosis due to an ambiguous clinical picture, which leads to significant morbidity. Management using an open surgical approach adds to the morbidity. We report a case of obstructed RPH which was treated pr...

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Main Authors: Kunal Vinayak, Abhinandan Mukhopadhyay, Shivam Mishra, Varun Mittal
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-04-01
Series:Indian Journal of Transplantation
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Online Access:https://journals.lww.com/10.4103/ijot.ijot_130_24
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author Kunal Vinayak
Abhinandan Mukhopadhyay
Shivam Mishra
Varun Mittal
author_facet Kunal Vinayak
Abhinandan Mukhopadhyay
Shivam Mishra
Varun Mittal
author_sort Kunal Vinayak
collection DOAJ
description Renal paratransplant hernia (RPH) is a rare type of internal hernia. There may be a delay in diagnosis due to an ambiguous clinical picture, which leads to significant morbidity. Management using an open surgical approach adds to the morbidity. We report a case of obstructed RPH which was treated promptly with minimally invasive technique. We aim to create clinical awareness about this rare diagnosis of common postoperative symptoms. A 56-year-old gentleman presented to us 1 month after kidney transplant with features of small bowel obstruction. Medical management was unsuccessful. Imaging showed herniation of the ileal loop into the abdominal wall with obstruction. A herniated small bowel loop in the retroperitoneal space through a peritoneal defect was seen. The loop was reduced laparoscopically and the peritoneal defect was not closed but simply incised and widened. Possible mechanisms of RPH formation are either iatrogenic defects of the peritoneum or spontaneous intraperitoneal rupture of lymphoceles. Due to immunosuppression, peritoneal signs may get masked hence the threshold for thoroughly investigating patients should be low. Minimally invasive techniques should be offered to these patients if there are no obvious contraindications.
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publisher Wolters Kluwer Medknow Publications
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series Indian Journal of Transplantation
spelling doaj-art-e94331c92cc64d0680c4ffddb62a96622025-08-20T02:44:20ZengWolters Kluwer Medknow PublicationsIndian Journal of Transplantation2212-00172212-00252025-04-0119225926110.4103/ijot.ijot_130_24Renal Paratransplant Hernia: A Rare Complication of Renal TransplantationKunal VinayakAbhinandan MukhopadhyayShivam MishraVarun MittalRenal paratransplant hernia (RPH) is a rare type of internal hernia. There may be a delay in diagnosis due to an ambiguous clinical picture, which leads to significant morbidity. Management using an open surgical approach adds to the morbidity. We report a case of obstructed RPH which was treated promptly with minimally invasive technique. We aim to create clinical awareness about this rare diagnosis of common postoperative symptoms. A 56-year-old gentleman presented to us 1 month after kidney transplant with features of small bowel obstruction. Medical management was unsuccessful. Imaging showed herniation of the ileal loop into the abdominal wall with obstruction. A herniated small bowel loop in the retroperitoneal space through a peritoneal defect was seen. The loop was reduced laparoscopically and the peritoneal defect was not closed but simply incised and widened. Possible mechanisms of RPH formation are either iatrogenic defects of the peritoneum or spontaneous intraperitoneal rupture of lymphoceles. Due to immunosuppression, peritoneal signs may get masked hence the threshold for thoroughly investigating patients should be low. Minimally invasive techniques should be offered to these patients if there are no obvious contraindications.https://journals.lww.com/10.4103/ijot.ijot_130_24complications of renal transplantinternal herniaparatransplant herniarenal paratransplant hernia
spellingShingle Kunal Vinayak
Abhinandan Mukhopadhyay
Shivam Mishra
Varun Mittal
Renal Paratransplant Hernia: A Rare Complication of Renal Transplantation
Indian Journal of Transplantation
complications of renal transplant
internal hernia
paratransplant hernia
renal paratransplant hernia
title Renal Paratransplant Hernia: A Rare Complication of Renal Transplantation
title_full Renal Paratransplant Hernia: A Rare Complication of Renal Transplantation
title_fullStr Renal Paratransplant Hernia: A Rare Complication of Renal Transplantation
title_full_unstemmed Renal Paratransplant Hernia: A Rare Complication of Renal Transplantation
title_short Renal Paratransplant Hernia: A Rare Complication of Renal Transplantation
title_sort renal paratransplant hernia a rare complication of renal transplantation
topic complications of renal transplant
internal hernia
paratransplant hernia
renal paratransplant hernia
url https://journals.lww.com/10.4103/ijot.ijot_130_24
work_keys_str_mv AT kunalvinayak renalparatransplantherniaararecomplicationofrenaltransplantation
AT abhinandanmukhopadhyay renalparatransplantherniaararecomplicationofrenaltransplantation
AT shivammishra renalparatransplantherniaararecomplicationofrenaltransplantation
AT varunmittal renalparatransplantherniaararecomplicationofrenaltransplantation