Obstructed urosepsis secondary to a ureteroinguinal hernia, managed with urgent hernia repair

Abstract

Obstructed urosepsis secondary to a ureteroinguinal hernia, managed with urgent hernia repairWe present a 74-year-old male who presented with obstructed urosepsis in the setting of a ureteroinguinal hernia, requiring urgent decompression. He was febrile to 38.8 C with borderline tachycardia and hypotension, urine dip was positive for nitrates and leukocytes. His lab results were, CRP 166, WCC 17, eGFR >90, and LFTs and electrolytes were unremarkable. He underwent a CT IVP (Fig. 1) demonstrating right hydronephrosis and hydroureter with delayed contrast emptying with a transition point at the distal ureter within a right inguinal hernia.The patient initially responded to broad-spectrum IV antibiotics and fluid resuscitation, on review of his scans and his clinical improvement with conservative management he was delayed for theatre and planned for a MAG3 to confirm obstruction. The