Presentation
Fever, dysuria. Rule out nephronia or abscess.
Patient Data
Normal-sized kidneys showing normal, symmetric nephrographic and pyelographic effect.
Right pelvic kidney. Mild dilatation of the right collecting system, bifid right ureter. The right ureter dips into a moderate-sized, fat-containing indirect right inguinal hernia.
Small superior calyceal diverticulum in left kidney. Small parapelvic cyst in right kidney, small cortical cyst in left kidney.
Catheterised bladder containing very little urine. Perivesical fat stranding possibly representing cystitis.
Enlarged prostate.
Small isodense, hypoenhancing focus with peripheral ring enhancement in the right part of the prostate - suspicious for an abscess.
Status post left inguinal hernia repair (moderate-sized left inguinal hernia containing a loop of descending colon-proximal sigmoid colon seen on MRI prostate [not shown] done two years earlier).
Case Discussion
Incidentally discovered loop of right ureter in an inguinal hernia, facilitated by the right kidney's low position and most probably accounting for the mild right-sided hydronephrosis.
Ureteroinguinal hernias are very rare, especially with native kidneys. The type seen here is the most common type, a paraperitoneal indirect inguinal hernia 1. Luckily for the patient, only the left inguinal hernia had been repaired; if the right hernia were operated on, there is a fair chance that the right ureter would have been injured.
Unable to process the form. Check for errors and try again.