Taskovska Milena, Janež Jurij
Department of Urology, University Medical Centre Ljubljana, Zaloška 7, 1000 Ljubljana, Slovenia.
Department of Abdominal surgery, University Medical Centre, Zaloška 7, 1000 Ljubljana, Slovenia.
Int J Surg Case Rep. 2017;40:36-38. doi: 10.1016/j.ijscr.2017.08.046. Epub 2017 Sep 5.
Inguinal bladder hernia is rare condition found in about 1-5% of inguinal hernias. The condition is usually diagnosed intraoperatively. Patients rarely have symptoms regarding urinary tract. The best management is surgical, open surgical technique is preferred over laparoscopic. Possible urinary tract damage during surgery should be recognized and resolved.
The following paper presents case of inguinal bladder hernia in 82-year old Caucasian male. Patient presented at our emergency department with incarcerated left inguinal hernia. Preoperative ultrasound has shown small bowel loop inside hernia sac. The condition was diagnosed intraoperatively - the whole bladder was found inside hernia sac. During surgery minor damage of the bladder was caused and repaired. Hernia defect was repaired using Bassini hernioplasty.
Elderly male more often present with inguinal bladder hernia. Sometimes urinary malignancy may be cause for inguinal bladder hernia. In cases where inguinal bladder is found inside hernia sac, urologist should be consulted to exclude urological pathology. Surgical treatment is indicated in all symptomatic patients. Patients with small, asymptomatic inguinal bladder hernias could be treated conservatively.
Physicians seeing patients with inguinal hernia should be aware that patient may have inguinal bladder hernia, especially in patients presenting with newly developed symptoms of lower urinary tract.
腹股沟膀胱疝是一种罕见病症,约占腹股沟疝的1 - 5%。该病通常在手术中被诊断出来。患者很少有泌尿系统相关症状。最佳治疗方法是手术,开放手术技术优于腹腔镜手术。手术过程中可能出现的尿路损伤应被识别并解决。
以下论文介绍了一名82岁白种男性腹股沟膀胱疝的病例。患者因左侧腹股沟嵌顿疝就诊于我院急诊科。术前超声显示疝囊内有小肠袢。术中诊断出该病症——发现整个膀胱位于疝囊内。手术过程中膀胱受到轻微损伤并进行了修复。采用巴西尼疝修补术修复疝缺损。
老年男性更常出现腹股沟膀胱疝。有时泌尿恶性肿瘤可能是腹股沟膀胱疝的病因。若在疝囊内发现腹股沟膀胱,应咨询泌尿科医生以排除泌尿系统病变。所有有症状的患者均需手术治疗。小型无症状腹股沟膀胱疝患者可保守治疗。
诊治腹股沟疝患者的医生应意识到患者可能患有腹股沟膀胱疝,尤其是出现新的下尿路症状的患者。