A Rare Case of Giant Inguinoscrotal Bladder Hernia as a Cause of Acute Respiratory Distress Syndrome

An inguinoscrotal hernia is a common condition in medical practice. However, an inguinoscrotal hernia involving the urinary bladder is a rare entity that can easily lead to diagnostic errors, resulting in inappropriate medical management. We report the case of a 77-year-old patient who presented to the emergency department with dysuria and testicular pain persisting for over a year. Clinical examination revealed a large, non-reducible inguinoscrotal hernia on palpation. Abdominopelvic computed tomography demonstrated a giant inguinoscrotal hernia containing almost the entire bladder, causing post-renal obstruction with upstream uretero-hydronephrosis. Emergency surgery was scheduled, involving inguinoscrotal hernia repair using the Lichtenstein technique. Postoperatively, the patient developed septic shock of urinary origin, complicated by severe acute respiratory distress syndrome (ARDS).