Unexpected inguinal hernia content: A case report of an ectopic kidney—Robot-assisted laparoscopic repair

Abstract

We present the case of an ectopic kidney located in the scrotum, discussing decision-making, surgical management, and outcomes. Although this is a rare pathology, we aimed to correlate this case with other reports of inguinal hernias and provide a literature review focusing on surgical and urological findings and management in similar patients. The patient is a 73-year-old man who presented with a progressive enlargement of his right inguinal area over the past 4 years. A routine computed tomography scan revealed an ectopic kidney in the scrotum, extending into a ~10 cm inguinal hernia, with severe hydronephrosis and a dilated ureter. Management options included nephropexy versus nephrectomy. A multidisciplinary approach involving general surgery and urology was employed, and the patient underwent a robot-assisted laparoscopic right inguinal hernia repair and kidney relocation. Postoperatively, renal function showed slight improvement, and no hernia recurrence was reported at the 6-month follow-up. This case highlights the importance of a multidisciplinary approach in the management of ectopic kidneys associated with inguinal hernias and contributes to the limited literature on this rare condition.

Keywords

Case report / ectopic kidney / inguinal hernia / minimally invasive surgery / nephropexy / robotic-assisted surgery / scrotal hernia

References

[1] Hammoud M , Gerken J . Inguinal hernia. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025.

[2] Jensen KK , Henriksen NA , Jorgensen LN . Inguinal hernia epidemiology. In: Textbook of Hernia. Cham: Springer; 2017. p. 23- 7.

[3] Shakil A , Aparicio K , Barta E , Munez K . Inguinal hernias: Diagnosis and management. Am Fam Physician 2020; 102: 487- 92.

[4] Lee CS , Kim JH , Choi BJ , Lee JI , Lee SC , Lee YS , et al. Retrospective study on prevalence of recurrent inguinal hernia: A large-scale multi-institutional study. Ann Surg Treat Res 2020; 98: 51- 5.

[5] Inguinal Hernia. NIDDK-National Institute of Diabetes and Digestive and Kidney Diseases; 2025. Available from NIH website.

[6] Kumar RA , Desai P , Iyer H , Moreira DM . Left kidney within a large left inguinal hernia. Urology 2019; 128: 5- 7.

[7] Kraft KH , Sweeney S , Fink AS , Ritenour CWM , Issa MM . Inguinoscrotal bladder hernias: Report of a series and review of the literature. Can Urol Assoc J 2008; 2: 619- 23.

[8] Presti JC , Narayan P . Lumbar herniation of the kidney. J Urol 1988; 140: 586- 7.

[9] Subramanian VS , Goldfarb DA . Right-sided intrathoracic renal ectopia with bochdalek's hernia. Urology 2008; 72: 1016- 7.

[10] Ramos AJ , Slovis TL , Reed JO . Intrathoracic kidney. Urology 1979; 13: 14- 9.

[11] Inokuchi R , Hashimoto K , Kobayashi H , Ishida T , Matsumoto A , Kumada Y , et al. Right kidney passing into the intrathoracic space after blunt abdominal trauma. Emerg Med J 2012; 30: 711.

[12] Fiaschetti V , Velari L , Gaspari E , Mastrangeli R , Simonetti G . Adult intra-thoracic kidney: A case report of bochdalek hernia. Case Rep Med 2010; 2010: 1- 6.

[13] Nephroptosis. Medscape.com; 2024. Available from Medscape website.

[14] Shchukin D , Demchenko V , Arkatov A , Stetsyshyn R , Khareba G , Bielov V , et al. "extreme nephroptosis": A kidney in the inguinal hernia. Case Rep Med 2023; 2023: 1- 5..

[15] Perone RW , Del Prado D , Katz DS . Pelvic kidney presenting as inguinal hernia and acute renal failure. AJR Am J Roentgenol 2007; 188: W305.

[16] Osmani HT , Boulton R , Wyatt H , Saunders SM . An unusual inguinoscrotal hernia with renal involvement. BMJ Case Rep 2015; 2015: bcr2015211519.

[17] Kim J , Harper B , Turner A , Gonzalez IA , Andrade A . Incarcerated native orthotopic kidney through an inguinal hernia: A case report and literature review. J Surg Case Rep 2023; 2023: rjad378.

[18] Gergel M , Brychta I , Lancz-Klikacova A , Mayer A . Nephroptosis and ureteroinguinal incarcerated hernia mimicking acute appendicitis. BMC Urol 2024; 24: 159.

[19] Wendler JJ , Baumunk D , Liehr U-B , Schostak M . Kidney dislocation in a monstrous inguinal intestinal hernia with ureteropelvic junction obstruction and acute on chronic renal failure. Urol Int 2013; 91: 370- 2.

[20] Shchukin D , Demchenko V , Arkatov A , Stetsyshyn R , Khareba G , Bielov V , et al. "Extreme nephroptosis": A kidney in the inguinal hernia. Case Rep Med 2023; 2023: 1439919.

[21] Cassidy DJ , Kotecha H , Sein V . Inguinal hernia containing a native orthotopic kidney. BMJ Case Rep 2019; 12: bcr- 2018.

[22] Hsabo EA , Aneke IA , Tuck J , Middela S . Scrotal kidney: A gross case of "nephroptosis". BJR Case Rep 2023; 9: 20220054.

[23] Senaratne R , Anderson S , Kelly C , Shannon N , O'Connor E , McGuire B , et al. Rolling in the deep: An illustrative report of symptomatic nephroptosis. Radiol Case Reports 2024; 19: 4044- 8.

RIGHTS & PERMISSIONS

International Journal of Abdominal Wall and Hernia Surgery | Published by Wolters Kluwer - Medknow on behalf of Higher Education Press