Inguinal hernia containing bladder

Case contributed by Dr Naresh Maheshwari

Presentation

Unexplained weight loss, CKD

Patient Data

Age: 86
Gender: Male
Modality: CT

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 calibre 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. Non complicated sigmoid diverticulosis

Case Discussion

Less commonly, inguinal hernias do involve 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 higher incidence of genitourinary cancers.

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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Case Information

rID: 32827
Case created: 17th Dec 2014
Last edited: 21st Sep 2015
System: Urogenital
Inclusion in quiz mode: Included

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