腹股溝陰囊膀胱疝氣：病例報告及文獻回顧
鍾卓興、鄒凱亦、胡書維、吳佳璋
行政院衛生福利部雙和醫院泌尿科
Inguinoscrotal bladder hernia: a rare case and literature review
Chung Cho-Hsing, Kai-Yi Tzou, Su-Wei Hu, Chia-Chang Wu
Departmentof Urology, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
Purpose:
To report a rare case of inguinoscrotal bladder hernia in a 79-year-old male that presented with acute urinary retention with fever.
Case presentation:
Acute urinary retention with fever was noted in a 79-year-old male, who living in nursing home. This is a case with history of Benign prostatic hyperplasia, Chronic kidney disease stage 3, Hypoxic ischemic encephalopathy with status epilepticus, Alzheimer's disease, Behavioral and psychological symptoms of dementia. This time, he was found short of breath with fever in the morning and then he was sent to emergency department. According to his caregiver, he suffered from progressive voiding difficulty these days, and also had progressive hematuria and pyuria. Other associated symptoms were much sputum, fever, and conscious change. PE showed large inguinal and scrotal mass. Therefore, foley was inserted and 1200ml urine was found. Lab data showed leukocytosis, normocytic anemia, electrolyte imbalance, hematuria and pyuria with bacteria, impaired renal function and elevated CRP. Chest X ray showed bilateral lower lobe increased infiltration. Abdomen and pelvic CT revealed inguino-scrotal bladder hernia. Cystography also showed Chronic cystitis. Under the impression of bilateral lower lobe pneumonia, urinary tract infection with sepsis, inguinoscrotal bladder hernia, the patient was admitted to our ward for further management. In this report, we will discuss the presentation and literature review of inguinoscrotal bladder hernia.
Conclusion:
Acute urinary retention with fever has to be considered in the differential diagnosis of inguinal hernias, especially in patients with obstructive symptoms of the bladder outlet.