Urinary Peritonitis After Inguinal Herniorrhaphy

Abstract

Urinary peritonitis is a rare but serious complication resulting from intraperitoneal bladder rupture, most commonly due to trauma or iatrogenic injury. Bladder injury during inguinal hernia repair is uncommon but may occur, particularly in cases of unrecognized inguinal bladder hernia.

We report the case of a 64-year-old man who developed urinary peritonitis five days after right inguinal herniorrhaphy. He presented with painful abdominal distension, generalized peritoneal irritation, anuria, and acute renal impairment. Imaging revealed intraperitoneal bladder rupture with a urinoma. Exploratory laparotomy confirmed a large bladder wall defect with massive uroperitoneum. Surgical repair with two-layer cystorrhaphy and drainage was performed, with favorable postoperative outcomes.

This case highlights the diagnostic challenges of postoperative urinary peritonitis and emphasizes the importance of suspecting bladder involvement during inguinal hernia repair. Early recognition and prompt surgical management are essential to prevent severe complications.