Ureterosciatic hernia with pyonephrosis and obstructive uropathy: a case report

• Published in: Hong Kong medical journal = Xianggang yi xue za zhi Vol. 27; no. 1; p. 50
• Main Authors: Chan, Clara YC, Lai, Terence CT, Yu, Chloe HT, Leung, Clarence LH, Chan, Wayne KW
• Format: Journal Article
• Language: Chinese; English
• Published: Hong Kong Hong Kong Academy of Medicine 01.02.2021
• Subjects: Abdomen; Asymptomatic; Disease; Hernias; Laparoscopy; Neuromuscular diseases; Surgery; Urology
• ISSN: 1024-2708; 2226-8707
• DOI: 10.12809/hkmj208542

Case report A 97-year-old woman with a history of ischaemic stroke, hypertension, hyperlipidaemia, and chronic obstructive pulmonary disease attended the Accident and Emergency department of Kwong Wah Hospital in January 2020 with a 1-day history of decreased general health and vomiting. Blood tests on admission revealed acute kidney injury with serum creatinine level of 387 μmol/L (baseline 73 μmol/L), leucocytosis (23.8 [x] 109/L), and elevated C-reactive protein level of 287 mg/L. Ureterosciatic herniation commonly occurs through the suprapiriformis compartment of the greater sciatic foramen.2 Herniation of the ureter into the greater sciatic foramen often results from piriformis muscle weakening due to increased pressure in the intra-abdominal area due to pregnancy, constipation, surgery, trauma, neuromuscular diseases, or hip disease.3 It commonly develops in elderly women due to their wider pelvic bones but congenital cases have also been reported.