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Erschienen in:
28.04.2016 | Letter to the Editor
Pathological changes in herniated organs: squamous metaplasia in an inguino-scrotal bladder hernia
Erschienen in: Hernia | Ausgabe 6/2016
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We read the article by Dr. Prete et al. with interest [1]. They reported an 83-year-old man with a large left inguino-scrotal hernia. The patient had a previous history of radiation treatment for squamous anal cancer. During hernia repair, they noticed that, a herniated portion of the left ureter was located alongside a large hernia sac, complicated by ureteral calculi. They extracted the stones, repaired the ureter, and performed a hernia repair with mesh. Accordingly, we presented an 82-year-old male presented with the complaints of dysuria, right-sided flank pain and scrotal mass. The physical examination revealed a large painless mass in the right groin area. He had no history of radiotherapy for any malignancy. Laboratory findings were unremarkable. Computed tomography (CT) imaging showed a right inguino-scrotal hernia including bladder and distal ureter. The patient underwent open surgery via an inguinal approach, and partial cystectomy was performed to excise the pathologically appeared bladder wall (Figs. 1, 2). In addition, inguinal hernia was repaired with the use of a prolene mesh. Pathologic examination revealed focal squamous metaplasia, ulceration and hyperemia of the bladder mucosa. The patient is well and under follow-up.
Fig. 1
Metaplastic mucosa of the urothelium was clearly demonstrated on direct vision during the operation
Fig. 2
On near view, the color difference between the bladder and herniated bladder sac was identified
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