Abstract

An 84-year-old male patient had suffered from generalized weakness and conscious change for one hour. A palpable, irreducible and painless mass was found in right groin for 30 years. The laboratory data showed elevated blood liver enzyme (glutamic oxaloacetic transaminase [GOT] = 50 U/L), decreased hemoglobin level (10.8 vs. 13.6 g/dL performed 8 days ago), and normal urine analysis. Contrast-enhanced computed tomography (CT) of the abdomen showed a 7.2 cm, oval, wall thickened mass of fluid density connecting to the urinary bladder with a funnel-shaped neck in right groin, coursing medial to the right inferior epigastric vessels and posterior to right inguinal ligament. A short segment of ileum was found in left groin with a course similar to the right-sided lesion. Therefore, CT diagnosis of right incarcerated femoral bladder hernia and left femoral bowel hernia was made. Attempt for manual reduction of the right incarcerated femoral hernia was failed. Surgical intervention was planned. However, the patient and his family refused operation. The patient was discharged with regular outpatient follow-up.

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