title: Kidney dislocation in a monstrous inguinal intestinal hernia with ureteropelvic junction obstruction and acute on chronic renal failure.
abstract: BACKGROUND
  Inguinal hernias are the most common hernias in adult males. Abnormalities should be taken into account for therapeutic procedures. This is the first report of a dislocation of a primary orthotopic kidney in a monstrous inguinal intestinal hernia.
  
  
  METHODS
  This paper reports an incidental finding of a dislocation of a primary orthotopic kidney in a monstrous inguinal intestinal hernia of an 82-year-old patient with intracranial injury and acute kidney failure. Post-renal kidney failure could be excluded by ultrasound and CT examination. The acute renal decompensation resulted from rhabdomyolysis associated with a falling down trauma with crush syndrome and pneumonic septicaemia based on chronic renal failure associated with nephrosclerosis and ureteropelvic junction obstruction conditioned atrophic right kidney.
  
  
  CONCLUSIONS
  Previous reports in the literature include inguinal-scrotal hernias containing ureter and bladder with post-renal failure or containing ectopic congenital pelvic or transplanted iliac kidney. Our patient is very unusual in that he presented with inguinal herniated, orthotopic, atrophic hydronephrosis with suspicion of congenital ureteropelvic junction obstruction as well as an asymptomatic large intestinal hernia. Reasons for pre-renal acute on chronic renal failure can make it difficult to arrive at a decision of a urological therapy.
authors.affiliation: Department of Urology and Paediatric Urology, Medical Faculty of the University of Magdeburg, Magdeburg, Germany.
authors.forename: J J
authors.initials: JJ
authors.lastname: Wendler
authors.forename: D
authors.initials: D
authors.lastname: Baumunk
authors.forename: U-B
authors.initials: UB
authors.lastname: Liehr
authors.forename: M
authors.initials: M
authors.lastname: Schostak
mesh_terms: D000369:Aged, 80 and over; D001930:Brain Injuries / Q000150:complications; D006552:Hernia, Inguinal / Q000150:complications*; D006801:Humans; D006869:Hydronephrosis / Q000150:complications; D007668:Kidney / Q000002:abnormalities; D007674:Kidney Diseases / Q000150:complications*; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D009400:Nephrosclerosis / Q000150:complications; D012206:Rhabdomyolysis; D018805:Sepsis / Q000150:complications; D014057:Tomography, X-Ray Computed; D014517:Ureteral Obstruction / Q000150:complications*; D014947:Wounds and Injuries