A Rare Case Report of Inguinal Herniation with Urinary Bladder as its Content

Background: Although inguinal hernias are common, cases of inguinal hernia involving the bladder were observed to be very rare (<5%). Diagnosis of Inguinal Bladder Herniation (IBH) is very challenging, and it was reported to be identified only in ≤10% of cases prior to an operation and ≤20% during surgical intervention. The majority of the patients are asymptomatic or have non-specific symptoms, making the condition difficult to diagnose pre-operatively. In many cases, the condition is usually diagnosed intraoperatively. Therefore, diagnosis, surgical planning, and careful management can play a vital role in avoiding any unwanted complications. Case Presentation: In the present case, a 60-year-old male patient with a known history of malignancy was presented to our hospital without any symptoms related to inguinal hernias. Conclusion: During his routine check-ups, the patient was fortuitously diagnosed with IBH. The patient underwent surgery, and the defect was repaired using Bassini hernioplasty without any complications. Postoperative recovery was uneventful. On follow-up, no pain or urinary-related symptoms were reported.

Herniation of ureter: a rare cause of hydroureteronephrosis

Background Omentum and bowel loops are commonly seen in inguinal hernia. An unusual case of extraperitoneal herniation of ureter was detected in hernial sac with other contents, on computed tomography (CT) urography. Case presentation A 54-year-old male presented with inguinal hernia, with no previous history of surgery or trauma. Pre-operative screening showed a unilateral hydroureteronephrosis involving the pelvicalyceal system and entire ureter. No calculus was visualized in the ureter on ultrasound. On non-contrast CT (NCCT) followed by CT urography, the ureter was seen descending into the hernia sac causing hydroureteronephrosis. The patient subsequently underwent mesh repair surgery of the inguinal hernia with meticulous reduction of the herniated contents including the ureter, resulting in complete resolution of the hydroureteronephrosis. Conclusion An isolated extraperitoneal inguinal herniation of the ureter without concomitant urinary bladder involvement is extremely rare, especially with no prior history of trauma or surgery, as seen in our case. The case also exemplifies the role of pre-operative imaging as a protocol in cases of inguinal hernia to prevent per-operative complications.

Inguinal hernias in elderly patients. Strategy for choosing a surgical treatment method

Objective: to evaluate the existing approaches to the treatment of inguinal hernias in the elderly and to propose a strategy for choosing the method of surgical treatment taking into account the metric assessment of the state of the topographical and anatomical parameters of the inguinal canal.Materials and methods. The analysis of surgical interventions for inguinal hernias in elderly patients in surgical in-patient clinics of the Grodno region over 2018–2019 was carried out. The morphometric parameters of the inguinal canal being determinants for choosing the method of hernioplasty were studied in 39 elderly patients.Results. The coefficient for choosing the method of inguinal herniation (K) has been proposed. It is calculated by the formula: К = h : m, where h is the height of the inguinal space (mm), m is the total thickness of the upper wall of the inguinal canal (mm). At K>4.83 they choose atension methods of hernioplasty.Conclusion. The use of the coefficient for choosing the method of inguinal hernioplasty has made it possible to reduce the number of recurrent hernias in the long-term postoperative period from 5.7 % to 2.0 % of cases.

Extraperitoneal laparoscopic repair of huge inguinoscrotal bladder hernia: a case report and literature review

Inguinal herniation of urinary bladder is a rare condition which might associated with significant complication. Exact pre-operative diagnosis is extremely important. We reported a case of huge inguinoscrotal bladder hernia, associated with bilateral hydronephrosis and kidney injuries, managed by laparoscopy technique.

Comparison of Incident of Chronic Pain Post Operations of Preperitoneal Transabdominal Herniorafi Laparoscopy (TAPP) and Totally Extraperitoneal (TEP) in General Hospital Dr. M. Djamil Padang

A B S T R A C TIntroduction : Inguinal herniation is a protrusion of peritoneal component throughabdominal wall caused by the weakness of aponeurotica tissue of abdomen. Inguinalherniation is the most common herniation cases in which 291.145 patient registeredin Indonesia at 2012 and 87 patients in General Government Hospital of M. DjamilPadang at 2017-2018. Herniation treatment is consisted of herniorrhapylaparoscopy using the TEP or TAPP techniques and both of them are related to theincidence of chronical post-operative pain that was defined by IASP as anuncomfortable sensation lasting for more than 3 months. Method: This researchwas using retrospective study design. The research was conducted at RSUP Dr. M.Djamil Padang in August – October 2020 with 54 samples. Result: The study foundthere was 54 cases of inguinal herniation fit to the inclusion criteria with peak ageof 82 years old and average of 59.1 years old. Most patients were male (79.62 %).There were 2 patients having chronic pain (7.41%) after herniorrhapy using the TAPPtechnique and 1 more (3.71%) having chronic pain with TEP technique. Bivariateanalysis was done by Fisher Exact Test and the study concluded there was nostatistical significance in relationship of chronic post-operative pain incidence withthe particular technique chosen at herniorrhapy laparoscopy (p=1.000). Conclusion:There was no significant relationship between the incidence of postoperative chronicpain in patients undergoing laparascopic hernioraphy and TEP or TAPP procedure.

An inguinal herniation of pregnant uterus in a Standard Wirehaired Dachshund – a case report

A 4-year-old intact female Standard Wirehaired Dachshund dog was referred with chief complaint of inguinal mass to the Small Animal Clinic at the University of Veterinary Medicine and Pharmacy in Košice, Slovakia. On physical examination, the bitch was healthy with no abnormalities other than having a non-painful and non-reducible soft tissue mass in the left inguinal region also involving the mammary gland. Ultrasonographic examination of the abdomen revealed a pregnant uterus and ultrasonography of the inguinal mass showed an organ with a lumen filled with anaechoic fluid. The diagnosis of a herniation was made and the owners decided for complete ovariohysterectomy. The left uterine horn had an incarcerated part of the inguinal hernia together with the ovary. Inside there was one macerated conceptus. The remaining part of the left uterine horn was located in the abdomen and had 2 macerated conceptuses. The bitch made an uneventful recovery from the surgery and anaesthesia with no postoperative complications and was sent home after the surgical procedure.

Traumatic inguinal hernia: An uncommonly reported entity

Traumatic abdominal wall herniation, especially of the groin region, is a rare condition and typically results from a high-energy trauma to the abdominal wall. We report a fatal case of a road-traffic collision involving a young male motorcyclist who collided with a speeding lorry. The victim sustained multiple injuries over the chest and abdomen, with traumatic inguinal herniation causing gross distension of the scrotum. At autopsy, multiple lacerations of thoracic and abdominal organs were seen, along with traumatic disruption of the right inguinal canal. The contused terminal ileum was present in the scrotal sac. A literature search has revealed a limited number of reported cases of gross inguinal herniation following thoracoabdominal trauma. In cases of high-energy trauma to the thoraco-abdominal region with unilateral or bilateral distension of the scrotum, the possibility of herniation of the abdominal contents into the scrotal sac should be considered by the forensic pathologist.

Inguinal hernia with complete urinary bladder herniation: a case report and review of the literature

Although inguinal hernias are common, inguinal herniation of the urinary bladder wall is rare. Moreover, the complete migration of the urinary bladder into the scrotum is considered less frequent. The majority of patients with bladder hernias are asymptomatic and diagnosis is made intraoperatively; however, difficulties in urination may lead to the correct diagnosis. We report about a case of a large right-sided scrotal hernia with complete bladder herniation presenting without urological symptoms.