Direct inguinal hernia containing a prolapsed bladder in an infant

Case report Direct inguinal hernias in children have been reported as ‘extremely rare’, with the reported incidence ranging between 0.2 and 0.9% of all inguinal hernia repairs [1–3]. Because of their rarity, they are often misdiagnosed and even missed during hernia repair [1]. There have been very few reports of visceral prolapse in a direct hernia in infants. A 24-week preterm male infant was born through cesarean section with hyaline membrane disease requiring ventilatory support in the neonatal intensive care and was noted to have bilateral reducible inguinal hernias. He developed two episodes of UTI and gross hematuria. Abdominal ultrasound revealed bilateral mild hydronephrosis. Voiding cystourethrogram was performed to rule out vesicoureteric reflux but revealed partial herniation of the bladder into the large left inguinal hernia (Fig. 1a).