A case of inguinal hernia with partial bladder herniation

Abstract

Introduction: Inguinal hernia repairs are commonly performed, and recurrence remains one of the well-known complications. In rare cases, intra-abdominal organs can become entrapped in the hernia sac, risking incarceration and subsequent strangulation if not managed promptly. Case Report: A 78-year-old male previously underwent bilateral inguinal hernia repair presented to the hospital with acute onset abdominal distension with associated nausea and emesis. He had noticed a progressively enlarging bulge in his left groin with fluctuating abdominal pain. Prior to his presentation, he had been struggling with incomplete voiding and frequent micturition managed unsuccessfully with tamsulosin. On examination, the patient’s abdomen was soft and non-tender, but visibly distended with a large incarcerated recurrent left inguinal hernia. The patient was admitted and subsequently underwent computed tomography (CT) abdomen and pelvis examination, which demonstrated mild distension of small bowel loops and an inguinal hernia with an encased segment of urinary bladder. The patient was managed conservatively and scheduled for an outpatient open hernia repair. Intraoperatively, multiple hernia sacs comprised of bladder were visualized extending into the suprapubic region. Each hernia sac was carefully opened and reduced without damage to the urinary bladder. Postoperatively, he recovered without complications and had complete symptom resolution. Conclusion: This case illustrates a rare complication of a common procedure that holds significant morbidity if not managed promptly. Identification of urinary bladder involvement is essential to reduce the risk of iatrogenic bladder damage during surgical repair of an inguinal hernia and to ensure complete symptom resolution for the patient.