A foreign body in inguinal canal: A case report

Abstract

Introduction: Inguinal bladder hernias are rare incidents accounting for 1-3% of all inguinal hernia. Most of those cases are discovered intraoperatively accounting for the high incidence of bladder injuries during the repair. Symptoms can be variable depending on the size of the herniated bladder.

Presentation of case: We present here a 70 years old obese male patient, with history of CVA & on regular Aspirin ingestion. He presented to the ER as a case of intestinal obstruction due to suspicion of strangulated inguinal hernia based on an unclear Ultrasound picture. He underwent an emergency exploration of the hernia where the balloon of a Foley's catheter was found inside a diverticulum of the urinary bladder, herniated through an Ogilvie hernia.

Discussion: Ogilvie hernia is a rare incident that happens mostly in elderly males. The herniated part contains prevesical fat, bladder andor loops of intestines. Diagnosis must be made preoperatively through CT scan or Cystourethrogram. First line management involves surgical reduction of the bladder and hernia repair. Resection of the herniated part is generally limited to necrotic tissues.

Conclusion: Surgeons must have high index of suspicion for elderly obese males with inguinal hernias and urinary or intestinal obstruction symptoms. Careful preoperative planning must be made to avoid repair associated bladder injuries.

Keywords: Case study; Complications; Foreign body; Inguinal canal; Retained item.

Fig. 1

Sliding Ogilvie hernia showing foreign body during the exploration of hernia.

Fig. 2

Balloon of a Foley’s catheter within the sliding part of the bladder in the inguinal hernia.