Mora Annalee, Oyenusi Opeyemi, Ghavamrezaii Amirali, Mohiuddin Safwan, Mitzov Nikolay
Internal Medicine, HCA Florida Healthcare Oak Hill Hospital, Brooksville, USA.
Cureus. 2023 Aug 8;15(8):e43139. doi: 10.7759/cureus.43139. eCollection 2023 Aug.
Inguinal hernia is a common condition that typically affects males in the age group of 50-70 years. While often asymptomatic or mildly symptomatic, complications such as urinary bladder herniation and obstructive uropathy can occur if left untreated. We present a unique case of a 60-year-old man with a body mass index of 37 kg/m with a 20-year history of untreated bilateral inguinal hernias. His condition progressed to a complicated right inguinoscrotal hernia involving the bladder, leading to obstructive uropathy, acute renal failure, and pulmonary edema. Diagnostic imaging revealed hydronephrosis and obstruction of the distal right ureter, necessitating several procedures, including diuretic therapy, a nephrostogram, a nephrostomy, and ultimately hemodialysis due to persistent renal failure. Surgical management was achieved through an emergent robotic-assisted repair of the right inguinal hernia using resorbable mesh while repairing the left hernia was delayed to mitigate potential risks. This case illustrates the severe complications that can arise from a longstanding untreated inguinal hernia, highlighting the importance of routine monitoring and early intervention. It also emphasizes the diagnostic role of different imaging modalities and immediate pharmacological and surgical intervention in managing such complications. Despite the commonality of inguinal hernia, a lack of timely treatment can lead to life-threatening conditions, necessitating a comprehensive approach to management to improve patient outcomes.
腹股沟疝是一种常见病症，通常影响50至70岁的男性。虽然通常无症状或症状轻微，但如果不治疗，可能会出现膀胱疝和梗阻性尿路病等并发症。我们报告一例独特病例，一名60岁男性，体重指数为37kg/m²，有20年未治疗的双侧腹股沟疝病史。他的病情发展为复杂的右侧腹股沟阴囊疝并累及膀胱，导致梗阻性尿路病、急性肾衰竭和肺水肿。诊断性影像学检查显示右肾积水和右侧输尿管远端梗阻，需要进行多项治疗，包括利尿治疗、肾造影片检查、肾造瘘术，最终因持续性肾衰竭进行血液透析。通过紧急机器人辅助使用可吸收补片修复右侧腹股沟疝实现手术治疗，而左侧疝的修复则推迟以降低潜在风险。该病例说明了长期未治疗的腹股沟疝可能引发的严重并发症，凸显了常规监测和早期干预的重要性。它还强调了不同影像学检查方法在诊断中的作用以及在处理此类并发症时立即进行药物和手术干预的必要性。尽管腹股沟疝很常见，但缺乏及时治疗可能导致危及生命的情况，因此需要采取综合管理方法以改善患者预后。
