Bladder calculi and ischemic bowel loop in association with inguinal sliding bladder hernia

Inguinal bladder hernia is a rare entity, accounting for 1%–4% of inguinal hernias, and the presence of bladder calculi within the herniated bladder is exceptionally uncommon. Preoperative imaging is essential to ensure diagnosis and prevent intraoperative complications. A 61-year-old male presented with abdominal pain, urinary symptoms, and a progressively enlarging left inguinoscrotal mass. Computed tomography demonstrated an incarcerated inguinoscrotal hernia containing a portion of the urinary bladder and small bowel. Laparoscopic transabdominal preperitoneal repair was initiated but converted to an open procedure due to bowel ischemia. A subtotal sliding bladder hernia with a non-iatrogenic bladder wall defect containing two calculi was identified. Cystorrhaphy and small bowel resection with stapled anastomosis were performed, followed by Bassini hernia repair. The postoperative course was uneventful. Inguinal bladder hernia with bladder calculi is extremely rare. Preoperative imaging is crucial for surgical planning, and an open approach may be preferable when bladder stones or strangulated bowel are present.