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Bladder incarceration with perforation in scrotal herniation: A case report.
Thomas Kunit1, Stephan Hruby1, Tobias Schaetz1
1Salzburg Medical School, Landeskrankenhaus Salzburg, Austria.
Summary
Inguinoscrotal hernias rarely involve the urinary bladder, and perforation is even rarer. This case highlights the severity of bladder perforation due to hernia, emphasizing prompt diagnosis and surgical intervention for sepsis.
Area of Science:
- Urology
- Surgical Gastroenterology
- Emergency Medicine
Background:
- Inguinoscrotal hernias are common, but bladder involvement is exceptionally rare.
- Bladder perforation within a scrotal hernia is a critical condition associated with high morbidity and mortality.
Purpose of the Study:
- To report a rare case of bladder perforation secondary to an incarcerated inguinoscrotal hernia.
- To emphasize the diagnostic utility of computed tomography (CT) with excretory phase in such cases.
- To highlight the successful surgical management and recovery.
Main Methods:
- A 93-year-old male presented with symptoms of a scrotal hernia.
- Diagnosis was confirmed using computed tomography (CT) with excretory phase.
- Surgical intervention involved laparotomy, partial bladder resection, and herniotomy.
Main Results:
- The patient had an incarcerated inguinoscrotal hernia with bladder perforation and severe sepsis.
- Post-operative recovery was uneventful.
- A follow-up cystography confirmed no urinary extravasation.
Conclusions:
- Bladder perforation due to inguinoscrotal hernia, though rare, is a life-threatening emergency.
- Prompt diagnosis with advanced imaging and surgical repair are crucial for favorable outcomes.
- This case underscores the importance of considering bladder injury in scrotal hernias.
