Question:

Which of the following is a true statement?
1. Inguinal herniation of ureter is an absolute indication of surgical correction.
2. Pre-surgical imaging with CT urogram is recommended for all hernia surgeries.
3. Ultrasonography is the gold standard for diagnosis of inguinal ureteral hernia.
4. CT urogram provides good anatomical detail of the ureter and can reliably diagnose inguinal ureteral hernia.
5. MRI is recommended in diagnostically equivocal cases.





Answer:

The correct answer for the question "Which of the following is a true statement?" is:

4. CT urogram provides good anatomical detail of the ureter and can reliably diagnose inguinal ureteral hernia.



Explanation
a. While surgical correction is indicated in all patients with evidence of ureteral obstruction, it is reasonable to monitor in patients without evidence of obstruction, especially in high surgical risk patients.

b. Inguinal ureteral herniation is a rare condition, and it is impractical to screen all patients undergoing herniorrhaphy with CT urogram.

c. While ultrasound is often the initial exam for detection of hydronephrosis, it is difficult to trace the ureter into the inguinal canal for reliable diagnosis of inguinal ureteral hernia.

d. CT urogram provides good anatomic details and should be the study of choice if inguinal ureteral hernia is of consideration.

e. The utility of MRI in diagnosis of inguinal ureteral hernia has not been studied.



From the manuscript:
Paraperitoneal Inguinal Hernia of Ureter
Radiology Case. 2012 Aug; 6(8):22-26


This article belongs to the GU section.




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From the manuscript

Paraperitoneal Inguinal Hernia of Ureter

Free full text article: Paraperitoneal Inguinal Hernia of Ureter

Abstract
Inguinal herniation of ureter is an uncommon finding that can potentially lead to obstructive uropathy. We report a case of inguinal herniation of ureter discovered incidentally during workup for acute renal failure and ultrasound finding of hydronephrosis.






References



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6. Golgor E, Stroszczynski C, Froehner M. Extraperitoneal Inguinoscrotal herniation of the ureter: a rare case of recurrence after hernia repair. Urol Ing 2009; 83: 113-115
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