Obstructive uropathy secondary to ureteral herniation in a pediatric en bloc renal graft.

Ureteral herniation is a rare entity. We report the first case of extraperitoneal ureteral herniation in a pediatric en bloc renal graft causing obstructive uropathy. A 70-year-old, obese patient with an en bloc renal transplant was found to have ureterohydronephrosis in the right renal graft on mag...

Descripción completa

Detalles Bibliográficos
Autores: Salinas Sánchez, Antonio Santiago, Cifuentes Tebar, Jesús, Segura Martín, Miguel, Giménez Bachs, José Miguel, Donate Moreno, María José, Pastor Navarro, Héctor, Virseda Rodríguez, Julio A.
Tipo de recurso: artículo
Fecha de publicación:2005
País:España
Institución:Universidad de Castilla-La Mancha
Repositorio:RUIdeRA. Repositorio Institucional de la UCLM
OAI Identifier:oai:ruidera.uclm.es:10578/34243
Acceso en línea:https://hdl.handle.net/10578/34243
Access Level:acceso abierto
Palabra clave:Complications
Obstructive uropathy
Renal transplant
Ureteral hernia
Descripción
Sumario:Ureteral herniation is a rare entity. We report the first case of extraperitoneal ureteral herniation in a pediatric en bloc renal graft causing obstructive uropathy. A 70-year-old, obese patient with an en bloc renal transplant was found to have ureterohydronephrosis in the right renal graft on magnetic resonance imaging. Nephrostomy with insertion of a double-J catheter confirmed the presence of a ureteral loop within the inguinal tract. Surgery confirmed herniation of the ureter through the internal inguinal ring, crossing over the spermatic cord. We performed release, resection, ureteral reimplantation and hernioplasty. Four months later, renal function was normal and urinary tract dilation had diminished. This case illustrates an unusual cause of obstructive uropathy in a transplanted kidney. Apart from obesity, two other factors may have contributed to its development: presence of a redundant ureter, and the fact that the ureter had been placed over, rather than under, the spermatic cord