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Case report
Obstructive uropathy in the context of ureteroinguinal hernia: experience of challenges in surgical management of an unwell patient
  1. Mitchell Egerton Barns1,
  2. Arvind Vasudevan1 and
  3. Emma Lucy Marsdin2
  1. 1Urology, Royal Perth Hospital, Perth, Western Australia, Australia
  2. 2General Surgery Department, John Radcliffe NHS Trust, Banbury, UK
  1. Correspondence to Dr Mitchell Egerton Barns; mitch{at}barnscorp.com

Abstract

This case exemplifies an unusual anatomical variation of a common presentation and highlights the importance of perioperative diagnosis and planning in complex surgical patients. A 72-year-old comorbid man presented to the emergency department with an infected obstructed right kidney secondary to an obstructing 12 mm vesicoureteric junction calculi. However, imaging also showed concurrent ureteroinguinal hernia associated with a 130 cm-long ureter, too long for conventional treatment with a ureteric stent. Acutely, the patient’s collecting system was decompressed via nephrostomy, but due to the rarity of this anatomical variation, definitive treatment had to be rethought to help reduce the risk of iatrogenic damage and the associated long-term complications.

  • urology
  • urinary tract infections
  • urological surgery
  • acute renal failure
  • interventional radiology

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Footnotes

  • Contributors MEB: primary author responsible for compiling the case report and writing it. ELM: supervising fellow who helped edit the paper and oversaw changes. AV: consultant urologist under which the patient was admitted, oversaw the report.

  • 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.