鼠径ヘルニア根治術3日後に発症した膀胱ヘルニアの1例

Abstract

A 72-year-old man complained of right hemiscrotal swelling and pollakisuria which had appeared 3 days after herniorrhaphy. On physical examination, a large mass in the right scrotum did not transmit light nor shrink upon pressure application. The concentrations of blood urea nitrogen and creatinine in the fluid obtained by puncture from the scrotal mass were high. Cystography demonstrated influx of contrast media into the scrotal mass from the bladder. From these findings, diagnosis was made as herniation of the bladder. An operation was performed through inguinoscrotal incision. The herniated bladder, to which peritoneum was laterally adherent, was incarcerated. The hernia ring, which was located medially to the suture line of previous herniorraphy, had strangulated the herniated bladder. The bladder wall was edematous and the mucosa was dark red. These findings suggested that the blood circulation in the herniated bladder had been disturbed for a relatively long time. Resection of the herniated bladder with the adherent peritoneum was performed in addition to hernia repair. Incomplete herniorrhaphy may be one of the causes of herniation of the bladder in our case.