Authors: Maan Jamjoom , Bsaim Abdulsalam Altirkistani , Abdulaziz Qashqari

Abstract

Background: Kidney transplantation is the preferred treatment for end-stage renal disease (ESRD) due to its superior outcomes compared to dialysis. However, complications such as infection, wound dehiscence, incisional hernia (IH), and rarely, renal paratransplant hernia (RPH) can occur post-transplant. This study reported a case of a patient with a post-renal transplant who presented abdominal symptoms requiring urgent laparotomy for an obstructed hernia at the transplant site.
Case Presentation: A 57-year-old male with non-alcoholic fatty liver disease, ESRD secondary to IgA nephropathy, myelofibrosis, and renal stones underwent a renal transplant from his son. He presented to the emergency department 6 days after he was discharged with severe abdominal pain, vomiting, and a visible bulge at the transplant incision. Ultrasound confirmed an IH with small bowel obstruction. Exploratory laparotomy successfully managed the hernia, and postoperative care included antibiotics and supportive measures. The patient recovered uneventfully and was discharged in good condition.
Conclusion: RPH represents a significant but uncommon complication following kidney transplantation. Timely identification and surgical intervention are essential for favorable outcomes. Despite the immunosuppressive risks, the incidence of RPH remains relatively low. Careful surgical planning is crucial to mitigate complications, and ongoing research is needed to refine treatment strategies, particularly exploring laparoscopic approaches in select cases.

Keywords: Case report, renal paratransplant hernia, hernia, emergency, incisional hernia, kidney transplant.