Article Text

Download PDFPDF
Case report
Rare giant inguinal hernia causing end-stage dialysis-dependent renal failure
  1. Jacob Levi1,
  2. Karl Chopra1,
  3. Mubashar Hussain2 and
  4. Shafiul Chowdhury3
  1. 1Accident and Emergency, Homerton University Hospital NHS Foundation Trust, London, UK
  2. 2General Surgery, Barts Health NHS Trust, London, UK
  3. 3Urology, Barts Health NHS Trust, London, UK
  1. Correspondence to Dr Jacob Levi; jacob.levi{at}


A 72-year-old man presented with urinary retention, weight loss, haematuria and severe acute kidney injury. He had never before been admitted to hospital and his past medical history included only an inguinal hernia. On examination, he appeared uraemic and had a right-sided painful hernia. A three-way catheter was inserted, bladder washouts performed and irrigation started. An ultrasound showed severe bilateral hydronephrosis and a ‘thickened bladder’ and this was thought to be obstructive uropathy secondary to bladder cancer. Twenty-four hours later his hernia doubled in diameter, became incarcerated and a CT of the abdomen and pelvis showed an inguinal hernia of both bladder and bowel, with the catheter tip inside the bladder hernia. He was taken to theatres and an open mesh repair was performed with a rigid cystoscopy to assist in locating and reducing the bladder. He required intensive care and dialysis postoperatively and remains on regular dialysis following discharge.

  • urology
  • surgery
  • acute renal failure

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors JL and KC wrote the manuscript with review and advice from SC and MH.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.