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腹股沟膀胱疝:一例病例报告及文献综述

Inguinal bladder hernia: A case report and literature review.

作者信息

Elkbuli Adel, Narvel Raed Ismail, McKenney Mark, Boneva Dessy

机构信息

Department of Surgery, Kendall Regional Medical Center, Miami, FL, USA.

Department of Surgery, Kendall Regional Medical Center, Miami, FL, USA.

出版信息

Int J Surg Case Rep. 2019;58:208-211. doi: 10.1016/j.ijscr.2019.04.040. Epub 2019 May 3.

DOI:10.1016/j.ijscr.2019.04.040
PMID:31078993
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6515135/
Abstract

INTRODUCTION

Cases of inguinal bladder hernia are rare, with bladder involvement seen in 1-4% of inguinal hernias. The majority of cases are diagnosed intraoperatively, with only 7% of bladder hernias identified prior to surgery. Diagnosis may be challenging as patients are often asymptomatic or have nonspecific symptoms. Surgical repair is currently the standard treatment, and careful surgical planning is necessary to avoid complications including bladder injury.

PRESENTATION OF CASE

A 58-year-old man presented to our Emergency Department with 2-day history of progressively worsening left lower quadrant pain, groin bulge, and dysuria. Physical exam revealed an irreducible left inguinal hernia associated with urinary urgency on attempted reduction. Plain CT was ordered and demonstrated inguinal hernia with bladder protrusion into the left scrotum. The patient underwent open surgical reduction and hernia repair and made a quick postoperative recovery without complications.

DISCUSSION

Inguinal bladder hernia most often presents in older, obese males and clinicians should have a high index of suspicion when assessing patients with inguinal hernia. Preoperative diagnosis based on history, physical, and radiologic imaging allow for careful surgical planning and prevention of severe complications including bladder injury and leakage.

CONCLUSION

We present a case report of inguinal bladder hernia in a middle-aged man that presented as left lower quadrant pain, groin pain, and dysuria. Diagnosis was confirmed preoperatively with radiographic imaging. The hernia was surgically reduced and the defect repaired without complications.

摘要

引言

腹股沟膀胱疝病例罕见,在腹股沟疝中膀胱受累的情况占1%-4%。大多数病例是在术中诊断出来的,术前仅7%的膀胱疝能被识别。由于患者通常无症状或仅有非特异性症状,诊断可能具有挑战性。手术修复是目前的标准治疗方法,需要仔细的手术规划以避免包括膀胱损伤在内的并发症。

病例介绍

一名58岁男性因左下象限疼痛、腹股沟肿块和排尿困难进行性加重2天就诊于我院急诊科。体格检查发现左侧腹股沟疝无法回纳,回纳尝试时伴有尿急。遂行平扫CT检查,显示腹股沟疝伴膀胱突入左侧阴囊。患者接受了开放手术回纳和疝修补术,术后恢复迅速,无并发症。

讨论

腹股沟膀胱疝最常发生于老年肥胖男性,临床医生在评估腹股沟疝患者时应高度怀疑。基于病史、体格检查和影像学检查进行术前诊断,有助于进行仔细的手术规划并预防包括膀胱损伤和渗漏在内的严重并发症。

结论

我们报告了一例中年男性腹股沟膀胱疝病例,表现为左下象限疼痛、腹股沟疼痛和排尿困难。术前通过影像学检查确诊。疝经手术回纳,缺损修复,无并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da2a/6515135/f214156e3679/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da2a/6515135/6be91599f4b8/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da2a/6515135/f214156e3679/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da2a/6515135/6be91599f4b8/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da2a/6515135/f214156e3679/gr2.jpg

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