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CASE REPORT   

Chirurgia 2019 October;32(5):272-4

DOI: 10.23736/S0394-9508.18.04901-X

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Bladder diverticulum in an inguinal hernia: pre- or intraoperative diagnosis?

Francesco DI MAGGIO 1 , Ryo FUKAURA 2, Aravind SHASTRY 2

1 Unit of Upper Gastrointestinal Surgery, Department of Surgery, Queens Hospital, Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK; 2 Unit of General Surgery, Department of Surgery, Medway Maritime Hospital, Medway NHS Trust, Gillingham, UK



Bladder diverticula in the context of inguinoscrotal hernias are extremely rare entities, therefore representing insidious conditions potentially escaping a proper workup and correct management. We here describe the case of a 43-year-old Caucasian man whose herniated bladder diverticulum we only discovered intraoperatively. The initial diagnosis, supported by recent US imaging, was that of a long-standing hydrocele, which was thought to be independent from an emergency onset of a strangulated ipsilateral hernia. It is well known that inguino-scrotal hernias can also have urological origins, which count up to 4%; however, these will often present as direct hernias where part of the bladder is protruding towards the transversalis fascia. Indeed, less than 20 cases of bladder diverticula herniating towards the scrotum are reported in the entire medical literature. In the presence of urological symptoms and a groin clinical examination suggesting the presence of a hernia, it is recommendable to proceed with an appropriate diagnostic path to exclude this rare condition, including a contrast cystography and, if necessary, a cystoscopy in order to establish the correct surgical approach.


KEY WORDS: Inguinal hernia; Bladder diverticulum; Diagnostics

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