A Case of Occult Hernia in a Pediatric Peritoneal Dialysis Patient Diagnosed in the Neonatal Period With Genital Edema

Abstract

Genital edema is a commonly reported complication in patients undergoing peritoneal dialysis (PD). It is typically caused by leakage of dialysis fluid into the subcutaneous tissue. This condition may be caused by a previous abdominal surgical wound or by a fragile peritoneal site such as an inguinal hernia. In this report, we present a case of occult inguinal hernia in a 1-month-old girl, whose primary symptom was genital edema. This symptom ultimately led to the diagnosis of an inguinal hernia. The patient experienced subcutaneous leakage of dialysate, which resulted in inadequate ultrafiltration. We performed inguinal hernia surgery and replacement of the PD catheter. The procedure successfully resolved the dialysis fluid leakage. No recurrence of dialysate leakage has been observed since the operation. In pediatric PD patients, peritoneal injuries can contribute to dialysate leakage; therefore, such injuries should be avoided whenever possible. Furthermore, recurrence of inguinal hernia is more common in pediatric PD patients than in the general pediatric population. Careful selection of surgical procedures is essential to minimize complications in this population.