Hernias complicating chronic ambulatory peritoneal dialysis in children

The sustained hydraulic pressure developed within the peritoneal cavity during chronic ambulatory peritoneal dialysis (CAPD) may develop any actual or potential defect in the inguinal or umbilical area into a clinical hernia. Seven of 19 children have developed inguinal hernias after initiation of CAPD. Demonstration of the presence of a processus vaginalis by peritoneography during catheter placement permits their repair at that time. Late development of clinical indirect inguinal hernias early in our experience after high ligation of the processus vaginalis emphasizes the fact that tight closure of the internal ring is necessary.