title: Giant anterior urethral diverticulum with a calculus masquerading as left inguinal hernia: A missed diagnosis, a lesson to learn.
abstract: Congenital anterior urethral diverticulum is an infrequent but important cause of infravesical obstructive uropathy in children. Clinical spectrum usually includes obstructive or irritative urinary symptoms or penile ballooning during the act of micturition. We share our experience in a case of giant anterior urethral diverticulum with a contained calculus presenting as a huge inguino-scrotal swelling and masquerading as left inguinal hernia. The fluctuation in the size of the swelling related to the act of micturition was mistaken for cough impulse. He was subjected to a left inguinal herniotomy, following which he developed urine leak from the surgery wound and was subsequently referred to our centre for further management. The importance of a detailed history, meticulous physical examination, and diagnostic imaging has been stressed. The surgical approach in such cases has also been highlighted.
authors.affiliation: Department of Pediatric Surgery, King George's Medical University, Lucknow, India.
authors.forename: Renu
authors.initials: R
authors.lastname: Kushwaha
authors.forename: Prabudh
authors.initials: P
authors.lastname: Goel
authors.forename: Shiv Narain
authors.initials: SN
authors.lastname: Kureel
keywords: Anterior urethral diverticulum; calculus; infra-vesical obstructive uropathy; inguino-scrotal swelling; left inguinal hernia
references.citation: ISRN Surg. 2011;2011:120307
references.pmid: 22084741
references.citation: Korean J Urol. 2012 Jul;53(7):505-7
references.pmid: 22866225
references.citation: Afr J Paediatr Surg. 2009 Jul-Dec;6(2):102-5
references.pmid: 19661640
references.citation: J Postgrad Med. 2006 Jan-Mar;52(1):73-4
references.pmid: 16534177
references.citation: Ultrasound Obstet Gynecol. 2005 Feb;25(2):202-3
references.pmid: 15685649
references.citation: Int J Urol. 2006 Apr;13(4):395-6
references.pmid: 16734857