# Dialysis and Abdominal Defects: Risk of a Massive Hernia When Starting Hemodialysis

## TL;DR

A patient on dialysis developed a massive hernia due to significant weight changes and delayed treatment, emphasizing the need for close monitoring in high-risk individuals.

## Contribution

This case highlights the rare but severe risk of massive hernia development in dialysis patients with rapid weight fluctuations.

## Key findings

- A 51-year-old male on dialysis developed a 25-30 cm giant hernia after a 190-pound weight fluctuation.
- Comorbidities like blindness and limited mobility contributed to delayed intervention and hernia progression.
- Surgical repair required multiple meshes due to the size and complexity of the hernia.

## Abstract

A giant inguinal hernia is an uncommon clinical challenge, particularly in developed countries where hernias rarely exceed 10 cm in size. In this present case, a 51-year-old male patient with end-stage renal disease (ESRD) on dialysis experienced a 190-pound weight fluctuation, which exacerbated a recurrent inguinal hernia into a giant hernia of 25-30 cm. The patient’s comorbidities of blindness and limited mobility likely contributed to delayed intervention and hernia growth. His surgical management required extensive hernia reduction and a repair with multiple meshes. This case highlights the impact of rapid weight changes on hernia progression and underscores the need for vigilant, interdisciplinary monitoring in high-risk patients.