Obstructive urosepsis caused by ureterosciatic hernia: A case report.

Obstructive urosepsis remains a critical condition requiring prompt diagnosis and treatment. Ureteral obstructions can arise from various causes, including anatomical anomalies. Ureterosciatic hernia (USH) is a rare but significant cause of such obstruction. Prior research has shown that USH involves the passage of the ureter through the greater sciatic foramen. This condition is often underdiagnosed due to its rarity and non-specific symptoms. No prior work had resolved the long-term outcomes of USH treatment. This gap motivated the need for case reports to expand clinical awareness. Understanding the clinical presentation and imaging findings is essential for early recognition. This paper contributes to the literature by describing a case of USH leading to obstructive urosepsis.

The aim of this case report is to describe the clinical course of a patient with obstructive urosepsis caused by ureterosciatic hernia. The specific problem addressed is the delayed diagnosis and management of this rare condition. The motivation for the study stems from the lack of detailed case reports on USH-related urosepsis. The authors sought to present a clear diagnostic and treatment approach for this condition. The case highlights the importance of imaging in identifying ureteral obstruction. The patient’s symptoms and imaging findings were evaluated to confirm the diagnosis. The treatment strategy focused on relieving the obstruction and preventing recurrence. This case provides insight into the management of USH in an elderly patient.

The patient underwent enhanced computed tomography to assess the extent of ureteral obstruction. The imaging findings were used to confirm the diagnosis of ureterosciatic hernia. Transurethral ureteral stenting was performed to relieve the obstruction. The procedure was guided by imaging to ensure proper stent placement. The patient’s symptoms were monitored following the intervention. Follow-up imaging was conducted to evaluate the success of the treatment. The stent was removed after eight months to assess for recurrence. The patient was observed for any signs of urosepsis or obstruction recurrence.

Enhanced computed tomography revealed left hydronephrosis and ureteral protrusion through the greater sciatic foramen. The patient was diagnosed with ureterosciatic hernia based on these findings. Transurethral ureteral stenting was performed to address the obstruction. The procedure led to a reduction in symptoms and improvement in renal function. The patient remained asymptomatic for eight months following stent placement. The stent was removed without complications after this period. No recurrence of ureteral obstruction was observed six months post-removal. The treatment was effective in managing the obstructive urosepsis caused by USH.

The authors propose that ureterosciatic hernia can present as obstructive urosepsis in elderly patients. The case demonstrates the effectiveness of ureteral stenting in managing this condition. The absence of recurrence after stent removal supports the long-term success of the treatment. The use of enhanced computed tomography was critical for accurate diagnosis. The clinical course of the patient supports the need for prompt intervention in USH cases. The authors suggest that USH should be considered in the differential diagnosis of ureteral obstruction. The case highlights the importance of imaging in confirming the diagnosis. These findings contribute to the limited literature on the management of ureterosciatic hernia.