Translate this page into:
Incidentally detected vesico inguinal hernia on fluoro-deoxy glucose positron emission tomography-computed tomography
Address for correspondence: Dr. Chidambaram Natrajan Balasubramanian Harisankar, Department of Nuclear Medicine and PET-CT, Amala Institute of Medical Sciences, Amala Nagar, Thrissur - 680 555, Kerala, India. E-mail: hari.cnb@gmail.com
This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
This article was originally published by Medknow Publications & Media Pvt Ltd and was migrated to Scientific Scholar after the change of Publisher.
Sir,
Herniation of the urinary bladder is rare and most cases are asymptomatic. They are incidentally noted during imaging or during the course of surgical repair. Though rare, compilations like acute renal failure, rupture, infection and calculus formation can occur. We report a case of vesicoinguinal hernia, detected incidentally on the whole body fluoro-deoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) study.
A 65-year-old man who presented with cervical lymph nodal enlargement was subjected to excision biopsy. Histopathology revealed metastases from poorly differentiated carcinoma. He was referred for a whole body FDG PET-CT study. PET scan [Figure 1] showed elevated FDG uptake in the surgical site. A suspicious soft-tissue nodule was noted near the deep lobe of left parotid gland. Incidentally, there was herniation of the urinary bladder into the right inguinal canal (a) urinary bladder herniation was clearly depicted in the coronal CT (b) and fused PET-CT (c) and the sagittal CT (d) and fused PET-CT (e) images.
Variety of incidental findings have been reported on FDG PET-CT studies. About 1-4% of all inguinal hernias involve the urinary bladder.[1] In aretrospective study of 662 patients with inguinal hernianly 2 patients had vesicoinguinal hernia.[2] Most cases are asymptomatic and are usually found incidentally on radiographic imaging or at the time of herniorrhaphy. Less than 7% of bladder hernias are diagnosed pre-operatively.[3] Only three cases of the urinary bladder herniation detected on FDGPET-CT have been previously reported.[456] Other incidental findings such as rupture[7] and vesico-colic fistula[89] have also been described in FDG PET studies.
REFERENCES
- Unusual contents of inguinal hernia sac. An approach to management. Surg Sci. 2011;2:322-5.
- [Google Scholar]
- Inguinoscrotal bladder hernias: Report of a series and review of the literature. Can Urol Assoc J. 2008;2:619-23.
- [Google Scholar]
- Inguino-scrotal herniation of urinary bladder diverticulum in a patient with pancreatic carcinoma : A potential pit fall in whole-body 18F-FDGPET-CT. Nuklearmedizin. 2008;47:N34-6.
- [Google Scholar]
- Inguinal herniation of a bladder diverticulum on PET/CT and associated complications. Clin Imaging. 2008;32:483-6.
- [Google Scholar]
- Inguinal herniation of a bladder diverticulum, diagnosed by PET-CT. Rev Esp Med Nucl. 2010;29:36-7.
- [Google Scholar]
- Extraperitoneal urinary bladder perforation detected by FDG PET/CT. J Radiol Case Rep. 2011;5:32-40.
- [Google Scholar]
- Diuresis makes vesico colic fistula visible on FDG PET/CT. Clin Nucl Med. 2011;36:49-51.
- [Google Scholar]
- Colovesical fistula in a patient with recurrent cervical cancer detected by FDG PET/CT. Clin Nucl Med. 2010;35:808-10.
- [Google Scholar]