Case report: post-renal acute kidney injury due to voluminous inguinoscrotal hernia

Resumo

Introduction: This case report describes a rare presentation of post-renal acute kidney injury caused by extrinsic compression of the urinary tract by a voluminous inguinoscrotal hernia in an elderly patient. The case is unique due to its unusual etiology and successful conservative management, adding to the medical literature the importance of considering this condition in the differential diagnosis of acute kidney injury.

Case Presentation: An 81-year-old male patient with a history of bilateral inguinoscrotal hernia since childhood, without previous treatment. Admitted with acute heart failure and progressive enlargement of the right hernia. During hospitalization, he developed acute kidney injury (KDIGO III) of post-renal etiology, confirmed by imaging studies that showed bilateral renal collecting system dilation and bladder distension, without significant prostatic changes. Management included indwelling urinary catheterization, resulting in progressive improvement of renal function. The patient refused surgical intervention and was discharged with conservative management.

Conclusion: This case highlights the importance of early diagnosis and multidisciplinary evaluation in atypical situations of post-renal acute kidney injury. Clinical resolution with conservative management, even in the presence of a voluminous hernia, offers a valuable lesson on individualized treatment and the need to consider uncommon etiologies.