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Article Details
Case Report
Volume 4, Issue 10 (October Issue)

Inguinal Hernia Causing Ureteral Obstruction with Hydronephrosis and Subsequent Urosepsis

Kevin Healey1, Ahmad O. Rifai2*, Alexander J. Maqueira3, Courtney Albury3 and William A. Kantrales3

1Lake Erie College of Osteopathic Medicine-Bradenton, Bradenton, FL 34211, USA

2The Virtual Nephrologist, INC, PO Box 1750, Lynn Haven, FL 32444, USA

3Alabama College of Osteopathic Medicine, 445 Health Sciences Blvd, Dothan, AL 36303, USA

*Corresponding author: Ahmad Oussama Rifai, The Virtual Nephrologist, INC, PO Box 1750, Lynn Haven FL 32444, USA. E-mail: aorifai@aol.com

Received: September 08, 2022; Accepted: September 16, 2022; Published: October 05, 2022

Citation: Healey K, Rifai AO, Maqueira AJ, et al. Inguinal Hernia Causing Ureteral Obstruction with Hydronephrosis and Subsequent Urosepsis. Clin Image Case Rep J. 2022; 4(10): 270.

Abstract

Introduction: Inguinal hernias are common anatomical deformities especially among men. Complications of inguinal hernias include incarceration, but incarcerated hernias rarely cause other disturbances.

Case Presentation: An 86-year-old man with a history of chronic kidney disease (stage IIIb), presented with recurrent urinary tract infections and acute kidney injury with sepsis. Physical examination revealed a right inguinal hernia, and computed tomography revealed right ureteral obstruction and distal entrapment by the inguinal hernia, with hydronephrosis. The patient underwent right retrograde pyelography and ureteral stent placement, followed by laparoscopic inguinal herniorrhaphy with mesh, which restored renal function. Our case is unique among obstructive uropathies due to inguinal hernias because the distal ureter was entrapped within the bowel mesentery communicating between the peritoneal cavity and retroperitoneum.

Conclusion: Both inguinal hernias and obstructive uropathy are common among elderly men. While the latter is often secondary to prostate malfunction, other causes of obstructive uropathy or hydronephrosis should be considered, especially if unilateral.

Keywords: Acute kidney injury; Hydronephrosis; Inguinal hernias; Obstructive uropathy; Sepsis