Right-sided Bochdalek hernia causing septic ureteric obstruction. Percutaneous treatment with placement of a nephroureteral double pigtail

Hatzidakis, Adam; Kozana, Androniki; Glaritis, Dimitrios; Mamoulakis, Charalampos

doi:10.1136/bcr-2014-207247

Cited by 7 publications

(20 citation statements)

References 15 publications

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“…Among the thoracic ureteral herniations reported in the literature, five presented with right flank pain [2, 3, 5, 6], three were incidental findings in the workup for azotemia [7], contralateral flank pain [8], and PET scan for the workup of a lung nodule [9]. Two cases presented as part of the workup for renal [10] and ureteral [11] stones, one presented as right upper quadrant abdominal pain [12], and one presented as septic obstructive pyelonephritis [13].…”

Section: Discussionmentioning

confidence: 99%

“…Of these reported cases, one was managed conservatively [7], three underwent surgical repair [3, 6, 10], and ureteral stenting [2–4, 11–13]. Among those that underwent stenting, one necessitated a nephrostomy access due to failure of retrograde stenting [13], another was followed by surgical repair [2], and one underwent intra-renal surgery with stenting [11]. Two cases did not report management [8, 9].…”

Section: Discussionmentioning

confidence: 99%

“…They are usually asymptomatic with prevalence rate reaching 10% [14]. In about 90% of the cases symptoms of Bochdaleck, hernias are left-sided [13]. However, in all reported cases of ureteral herniation, the herniation lateralized to the right-side.…”

Section: Discussionmentioning

confidence: 99%

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A Rare Case of Isolated Ureteral Diaphragmatic Herniation: Case Report and Review of Literature

Heidar

Elsemesmani

Elamine

et al. 2019

Case Reports in Urology

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Diaphragmatic ureteral hernias are rare causes of ipsilateral renal obstruction. Management strategies varies from conservative to ureteral stenting to operative herniorraphy and reduction. We present a case of a 71-year-old man who was found to have an incidental right ureteral diaphragmatic herniation causing an asymptomatic kidney obstruction. He was managed conservatively with no evidence of increased hydronephrosis on serial imaging and no deterioration of biochemical renal function. We review all similar cases published in the literature and discuss the optimal treatment strategies.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A Rare Case of Isolated Ureteral Diaphragmatic Herniation: Case Report and Review of Literature

Heidar

Elsemesmani

Elamine

et al. 2019

Case Reports in Urology

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“…If symptomatic, they can present with flank pain, gross hematuria, renal dysfunction, nephrolithiasis, and urosepsis [11, 13]. While these symptoms are non-specific, and the likelihood of diagnosing a herniated ureter is low, the consequences of misdiagnosis can result in permanent ureteral injury, loss of renal function, and/or urosepsis.…”

Section: Discussionmentioning

confidence: 99%

A rare diaphragmatic ureteral herniation case report: endoscopic and open reconstructive management

Lin

Kim

et al. 2017

BMC Urol

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BackgroundUreteral herniations are a rare occurrence, generally found incidentally on cross sectional imaging or during surgical intervention for unrelated processes. Several locations of ureteral herniations can occur including the inguinal, femoral, sciatic, obturator, and thoracic regions. While few reports of ureteral hernias are reported in the literature overall, the vast majority of those reported are inguinoscrotal herniations found during evaluation and treatment of inguinal hernias. Pelvic outlet ureteral herniations intrinsically are more common secondary to their dependent locations. Intrathoracic ureteral herniations through diaphragmatic defects are an exceptionally rare subset of ureteral herniations and have only been described sparingly. Fewer than ten case reports of diaphramatic ureteral herniations have been reported and none have described both cystoscopic management and open reconstruction.Case presentationWe report the case of a 81 year old female with flank pain who was found to have idiopathic diaphragmatic hernia with incarcerated proximal ureter. She had no prior injury or surgery that explained her clinical presentation. She was initially observed and then managed conservatively with ureteral stent exchanges. Ultimately she underwent open surgical repair of her diaphragmatic hernia, reduction, resection and anastomosis of redundant proximal incarcerated ureteral segment, and nephropexy for a hypermobile right renal unit. This case report illustrates the pre- and post-operative imaging studies of a very rare intrathoracic ureteral herniation as well as surgical approach to repair.ConclusionA herniated ureter is a potential source of serious renal and ureteral complications. The thoracic herniation of ureter is the rarest of the ureteral herniations. When discovered, they should be managed to preserve renal function and prevent strangulation of the affected segment of ureter. This case report documents the treatment of a thoracic ureteral herniation with observation, conservative endoscopic management, and finally open surgical reconstruction.

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“…4,10 The clinical presentation of a right sided Bochdalek hernia can also manifest as strangulation of the contents of hernia, colon necrosis, hemothorax, septic ureteric obstruction which can be life threatening and need urgent surgical intervention. 10,11,12 The suspicion of presence of Bochdalek hernia can be made by conventional radiological methods like plain radiographs and barium studies. Diagnosing this condition in an adult is rather difficult, and on most occasions, purely incidental.…”

Section: Discussionmentioning

confidence: 99%

Unusual Presentation of Right Sided Bochdalek Hernia in an Adult

Chandra¹,

Chaudhary²,

Srivastava³

et al. 2015

jebmh

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Herniation of abdominal content through a persistent embryonic pleuroperitonial hiatus is most common form of congenital diaphragmatic hernia. Bochdalek hernia is a congenital anomaly in neonatal and postnatal patients and occur in about one in 2,200 to 12,500 live births, but it is rare in adults. 1 75% to 90% occur on left side. 2,3,4 Here we present a rare case of 24 years old male patient with Bochdalek hernia on right side.

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Right-sided Bochdalek hernia causing septic ureteric obstruction. Percutaneous treatment with placement of a nephroureteral double pigtail

Cited by 7 publications

References 15 publications

A Rare Case of Isolated Ureteral Diaphragmatic Herniation: Case Report and Review of Literature

A Rare Case of Isolated Ureteral Diaphragmatic Herniation: Case Report and Review of Literature

A rare diaphragmatic ureteral herniation case report: endoscopic and open reconstructive management

Unusual Presentation of Right Sided Bochdalek Hernia in an Adult

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