Indirect inguinal hernia in CAPD patients with polycystic kidney disease.
We have experienced a high incidence of indirect inguinal hernias occurring in the first few months of starting CAPD in male patients with autosomal dominant polycystic kidney disease (PKD). Out of 13 patients with P.C.K. on CAPD one (7.7%) had inguinal herniorraphy at an early age and six (46.2%) developed bilateral indirect inguinal hernia during CAPD. In comparison only one of 30 other male patients on CAPD developed indirect inguinal hernia and none had any evidence of previous inguinal herniorrhaphy or of indirect inguinal hernia on clinical examination. Five out of seventeen (29.4%) male patients with P.C.K. on hemodialysis or conservative treatment of renal impairment had history of inguinal herniorrhaphy or an evidence of inguinal hernia on clinical examination. This compares with a rate of herniorrhaphy performed for indirect inguinal hernia approximately 1.5 per 1000 population. In one patient on CAPD a peritoneogram using 99m Tc sulfur colloid suggested a patent processes vaginalis to account for scrotal edema on one side; the patient subsequently developed an indirect inguinal hernia on the other side just a few months after the repair. In view of high association of patent processus vaginalis with P.C.K. we recommend it is routinely searched in this group of patients and repaired at time of CAPD catheter insertion.
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Renal Unit, Stobhill General Hospital, Glasgow, Scotland, U.K.
Grant
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Garret
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Rodger
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RS
D006552:Hernia, Inguinal / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000628:therapy; D008297:Male; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D007690:Polycystic Kidney Diseases / Q000150:complications*