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一例罕见的巨大腹股沟阴囊膀胱疝致急性呼吸窘迫综合征

A Rare Case of Giant Inguinoscrotal Bladder Hernia as a Cause of Acute Respiratory Distress Syndrome.

作者信息

Neff Thomas, Amicone Caroline

机构信息

Intensive Care Unit, Centre Hospitalier Universitaire UCLouvain Namur, Godinne, BEL.

Intensive Care Unit, Centre Hospitalier Universitaire - Liège, Liège, BEL.

出版信息

Cureus. 2025 Feb 23;17(2):e79518. doi: 10.7759/cureus.79518. eCollection 2025 Feb.

Abstract

An inguinoscrotal hernia is a common condition in medical practice. However, an inguinoscrotal hernia involving the urinary bladder is a rare entity that can easily lead to diagnostic errors, resulting in inappropriate medical management. We report the case of a 77-year-old patient who presented to the emergency department with dysuria and testicular pain persisting for over a year. Clinical examination revealed a large, non-reducible inguinoscrotal hernia on palpation. Abdominopelvic computed tomography demonstrated a giant inguinoscrotal hernia containing almost the entire bladder, causing post-renal obstruction with upstream uretero-hydronephrosis. Emergency surgery was scheduled, involving inguinoscrotal hernia repair using the Lichtenstein technique. Postoperatively, the patient developed septic shock of urinary origin, complicated by severe acute respiratory distress syndrome (ARDS).

摘要

腹股沟阴囊疝是医疗实践中的常见病症。然而,累及膀胱的腹股沟阴囊疝是一种罕见情况,容易导致诊断错误,进而造成不恰当的医疗处理。我们报告一例77岁患者,因排尿困难和睾丸疼痛持续一年多就诊于急诊科。临床检查触诊发现一个巨大的、不可复性腹股沟阴囊疝。腹盆腔计算机断层扫描显示一个巨大的腹股沟阴囊疝,几乎包含整个膀胱,导致肾后梗阻及上游输尿管肾盂积水。安排了急诊手术,采用利chtenstein技术进行腹股沟阴囊疝修补。术后,患者发生源于泌尿系统的感染性休克,并并发严重急性呼吸窘迫综合征(ARDS)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ea5/11936430/e2e7dc6ccb4c/cureus-0017-00000079518-i01.jpg

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