Transplant uretero-inguinal hernia resulting in urosepsis
Uretero-inguinal hernias are rare and can be difficult to diagnose.

Published in the journal Radiology Case Reports, the authors present a case of a rare transplant kidney uretero-inguinal hernia.

An 81-year-old male presented with urosepsis and was found to have an obstructed transplanted kidney secondary to herniation of the ureter into an inguinal hernia.

The patient required interventional radiology decompression of the urinary system with a percutaneous nephrostomy tube.

In this case, the patient's uretero-inguinal hernia was the extraperitoneal subtype allowing the diagnosis to be made easily on computed tomography imaging of the abdomen and pelvis which facilitated rapid treatment.

Learning Points:-
• Uretero-inguinal hernias are rare and can lead to many complications which include loss of renal function, hydronephrosis, and urosepsis. However, surgery maybe deferred to a later time with the placement of a nephrostomy tube.

• Moreover, failure to diagnose the presence of a herniated ureter prior to surgery puts patients at great risk for iatrogenic ureteral injury.

• Clinicians with a high index of suspicion may consider obtaining CT urograms, or IV and retrograde pyelograms when conventional CT scans of the abdomen and pelvis fail to identify the herniated ureter.

• Given that injury to the ureters is a serious complication that requires additional surgical repair, it is important for clinicians to be aware of this rare type of hernia.

Read in detail about the case here:
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