Clinical Practice and Cases in Emergency Medicine

Introduction: Inguinal bladder herniation is a rare subtype of inguinal hernia in which the urinary bladder protrudes into the inguinal canal. It is often asymptomatic but can present with a range of clinical severity in the emergency department (ED).

Case Report: We present a case report of two patients with inguinal bladder hernias. The first case describes a stable patient with bladder herniation without urinary obstruction, successfully managed with outpatient follow-up. The second case illustrates a more severe presentation with bladder involvement causing bilateral hydroureteronephrosis, requiring admission after failed reduction. This patient subsequently re-presented with urosepsis and developed multiple complications, including bacteremia and infective endocarditis.

Conclusion: Inguinal bladder herniation can present with a wide clinical spectrum in the ED. Early recognition, appropriate imaging, and thorough clinical assessment are critical in guiding management and preventing complications.