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Query: UMLS:C0019270 (hernia)
 15,856 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This paper describes the incisional hernia repair technique carried out on 50 patients with chronic renal insufficiency requiring continuous ambulatory peritoneal dialysis. The technique involved fixing a polypropylene mesh prosthesis to the deep face of lateral incisions into the aponeurosis of the rectus abdominis muscle. Under general or epidural anaesthesia the old scar was resected and the hernial sac dissected, care being taken not to open the peritoneum. At 5 cm from either side of the hernia margin, the aponeurosis was incised longitudinally and the adjacent muscle separated. The mesh was sutured to the deep face of the aponeurosis, covering the hernial defect. A Tenckhoff catheter was left in the abdominal cavity. Peritoneal dialysis was given to all 50 patients in the immediate postoperative period, with no leaking of the dialysis fluid. One year later there has been no recurrence. Prosthetic mesh fixed to the deep face of the abdominal aponeurosis at incisions lateral to the hernia margins, without opening the peritoneum, is an effective treatment of incisional hernia repair for patients on peritoneal dialysis and allows early institution of dialysis.
Hernia 2001 Mar
PMID:Abdominal wall hernia repair in patients with chronic renal failure and a dialysis catheter. 1138 29

Cystic renal lymphangiectasia (CRL) is a rare malformation of lymphatics that can present in childhood and adulthood. Symptoms and radiologic features are relatively well defined, but clinical evolution and prognosis remain unclear. We treated a boy with CRL who developed chronic renal insufficiency. The first manifestation was abdominal swelling associated with an umbilical hernia noted incidentally at 1.6 years. Computed tomography with intravenous contrast administration demonstrated perirenal cysts with fluid collection, suggesting CRL. Intractable ascites resisted pharmacologic treatments such as diuretics. After approximately 7 years, the ascites resolved spontaneously, but the perirenal cysts persisted. At 11 years, proteinuria was noted. A renal biopsy specimen showed interstitial abnormalities consistent with CRL, glomeruli showed a focal segmental mesangial increase. Proteinuria persisted despite administration of an angiotensin-converting enzyme inhibitor, increasing as obesity and hypertension worsened. Renal function gradually declined in the ensuing years. Polycythemia coexisted with a normal serum erythropoietin concentration. A follow-up renal biopsy specimen disclosed glomerular enlargement together with focal segmental mesangial expansion, suggesting obesity-related glomerulopathy. Our observation suggest that under some specific circumstances like our patient CRL may exacerbate. Management of complicating obesity and hypertension are likely to be important for maintaining normal renal function, especially in the diffuse bilateral type of CRL present in our patient.
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PMID:Chronic renal insufficiency in a boy with cystic renal lymphangiectasia: morphological findings and long-term follow-up. 1818 26