Inguinal Swelling
Case History: 65-year-old male with swelling of left inguinal region for two months.
Case History: A 65-year-old male presents with swelling over left inguinal region for two months.On examination, cough impulse was present.
On examination, cough impulse was present.
Figure 1. On plain CT axial scan (a) and on venous phase (b), a defect is noted in left inguinal region through which sac arising from urinary bladder herniates. On delayed CT axial scan (c), contrast enhancement seen in urinary bladder also appears to fill the herniated sac as well (d) suggestive of urinary bladder.
Figure 2. On venous phase CT sagittal scan (a) and venous phase CT coronal scan (c), a defect is noted in left inguinal region through which sac arising from urinary bladder herniates. On delayed CT sagittal scan (b) and delayed CT coronal scan (d), contrast enhancement seen in urinary bladder also appears to fill the herniated sac suggestive of urinary bladder.
Figure 3. On T2 sagittal MRI image (a) and T2 coronal MRI image (b), bladder is seen to herniate through left inguinal region. Fluid filled herniated sac appears hyperintense on T2. On T1 sagittal MRI image (c) and T1 coronal MRI image (d), bladder is seen to herniate through left inguinal region. Fluid filled herniated sac appears hypointense on T1.
On contrast-enhanced CT, a defect of size (3.7 Ã 2.7 cm) was noted in the left inguinal region.
Most bladder hernias involve the inguinal and femoral canals.
Only about 7% of bladder hernias are diagnosed preoperatively.
Bladder hernias have been classified into three types: paraperitoneal hernia, intraperitoneal hernia, and extraperitoneal hernia.
In this case, the bladder hernia is paraperitoneal, indirect type as described above.
