Recurrent obturator hernia in a patient with autosomal dominant polycystic kidney disease undergoing peritoneal dialysis: a case report.

Abstract

Obturator hernia, a rare condition that accounts for only 0.07-1% of all hernias, typically occurs in older adult, thin, multiparous women owing to weakening of the obturator membrane and increased intra-abdominal pressure. Conditions such as chronic constipation, chronic obstructive pulmonary disease, ascites, peritoneal dialysis (PD), and autosomal dominant polycystic kidney disease (ADPKD) are considered risk factors for an obturator hernia. Diagnosis is often delayed because of nonspecific symptoms, and computed tomography imaging is essential for early detection. We report the case of a 69-year-old woman with ADPKD undergoing PD who developed a right-sided obturator hernia, followed by contralateral recurrences within 3 months. The initial and recurrent hernias were managed with open surgical repair using simple suture techniques. The patient's enlarged kidneys and liver, combined with dialysate fluid, may have contributed to sustained elevated intra-abdominal pressure, increasing the risk for hernia recurrence. This case highlights the unique combination of ADPKD and PD as potential contributors to obturator hernia recurrence.