Massive inguinal herniation of the bladder with bilateral hydronephrosis, complicated by psychosis.
N J KinnearDerek Barrry HennesseyPublished in: BMJ case reports (2023)
Massive inguinal herniation of the bladder is rare. This case was made more dramatic by the late presentation and simultaneous psychiatric condition. A man in his 70s was found in his burning house and admitted for smoke inhalation. Initially refusing examination or investigation, on the third day, he was found to have massive inguinal bladder herniation, bilateral hydronephrosis and acute renal failure. After urethral catheterisation, bilateral ureteric stent insertion and resolution of postobstructive diuresis, the patient underwent open right inguinal hernia repair and return of the bladder to its orthotopic position. He also diagnosed with schizotypal personality disorder with psychosis, malnutrition, iron deficiency anaemia, heart failure and chronic lower limb ulcers. Four months later and after multiple failed trial of voids, the patient underwent transurethral resection of prostate with successful resumption of spontaneous voiding.
Keyphrases
- case report
- spinal cord injury
- iron deficiency
- lower limb
- heart failure
- prostate cancer
- urinary tract
- radical prostatectomy
- benign prostatic hyperplasia
- liver failure
- mental health
- minimally invasive
- drug induced
- intensive care unit
- respiratory failure
- phase ii
- single molecule
- mechanical ventilation
- double blind
- placebo controlled