Presentation
Unexplained weight loss, CKD
Patient Data
There is herniation of the antero-lateral wall of the bladder in the right inguinal canal. No upstream distension of the ureter or pelvicalyceal system on the right side.
Also noted was ballooning and gross distension of left pelvicalyceal system with normal caliber of the ureter in keeping PUJ stricture. Bilateral renal cortical thinning is demonstrated. A large cortical cyst is seen in the upper pole of the left kidney. Prostatomegaly with calcifications. Noncomplicated sigmoid diverticulitis.
Case Discussion
Less commonly, inguinal hernias do involve the bladder wall. In our case, it was discovered incidentally but it is important to identify the pathology as these are often associated with complications such as UTI, obstructive uropathy, and bladder infarctions. In addition, these patients may have a higher incidence of genitourinary cancers.
The commonest age group is 50-70 years.
Ultrasound or CT may be done initially to establish the diagnosis. Previously IVU or cystograms were also performed as part of the radiologic investigations.
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