Rare case of inguinal ureteral hernia in a child diagnosed by drip infusion pyelography-computed tomography

Area of Science:

• Pediatric Surgery
• Urology
• Radiology

Background:

• Inguinal hernias are common in pediatric surgery, but urinary system organ prolapse is rare.
• Inguinal ureteral hernias are infrequently documented in pediatric populations.
• Paraperitoneal inguinal hernias may be linked to vesicoureteral reflux and posterior urethral valve.

Purpose of the Study:

• To present a rare case of congenital paraperitoneal inguinal herniation of the ureter in a child.
• To discuss the diagnostic challenges and surgical management of pediatric inguinal ureteral hernias.
• To highlight the importance of accurate diagnosis and tailored surgical intervention.

Main Methods:

• A case of a 14-year-old boy with congenital paraperitoneal inguinal herniation of the ureter was reported.
• Intraoperative findings included an unusual tubular loop structure in the inguinal canal, presumed to be the ureter.
• The ureter was intentionally left in the inguinal canal to prevent damage, followed by postoperative imaging and long-term follow-up.

Main Results:

• Postoperative drip infusion pyelography-computed tomography revealed ureteral anatomical irregularity within the inguinal canal.
• Five-year follow-up demonstrated no hydrocele recurrence or ureteral obstruction complications.
• The patient experienced transient hematuria following the intraoperative decision to leave the ureter in place.

Conclusions:

• This case underscores the diagnostic complexities and management strategies for pediatric inguinal ureteral hernias.
• The decision to preserve the ureter in situ, while avoiding immediate damage, led to a favorable outcome.
• Accurate diagnosis and individualized surgical approaches are crucial for managing this rare condition.