Shannon Fraser

A 92-year-old man with chronic kidney disease (baseline creatinine 120 μmol/L) developed acute kidney injury (highest creatinine 422 μmol/L) while hospitalized following his third myocardial infarction. He had no pain or lower urinary tract symptoms, but had noticed a bulge in his left inguinal area for the previous 2 years. Physical examination showed that the patient was frail, with a large, partially reducible, left inguinal mass.