Incidentally detected inguinal herniation of urinary bladder in whole body skeletal scintigraphy

Herniation of urinary bladder is rare [1] and when present, it commonly involves either inguinal or femoral canal accounting for almost 1-3 % of all inguinal hernias [2]. Very often such hernias are asymptomatic and turns out to be an incidental finding in an imaging carried out for some other clinical indications [3]. Inguinal hernias may be direct or indirect. Indirect inguinal hernia protrudes through the inguinal region and is due to the failure of embryonic closure of the internal inguinal ring after the testicle passes through it. Direct inguinal hernia enters through a weak point in the fascia of abdominal wall (Hasselbachs triangle) [2]. Ischiorectal, obturator & abdominal wall, though rare, are the other sites through which urinary bladder can herniated [4]. Inguinal hernias of bladder are classified with regard to their relation to the peritoneum as: a) paraperitoneal hernias where bladder remains extraperitoneal & is medial to the peritoneal herniation.b) intraperitoneal hernia where bladder is completely covered with peritoneum in the hernial sac & c) extraperitoneal hernias where peritoneum remains in the abdomen & the bladder alone herniates [5].