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A 68-year-old man with chronic dysuria and increased urinary frequency presented with three weeks of weakness and fever. Physical examination revealed a man with cachexia who had a large, right-sided inguinal hernia that had been enlarging for more than eight years (Panel A). Computed tomography revealed unobstructed bowel within the hernia sac (Panel B, arrows). A urinary tract infection was diagnosed, and the patient received a course of levofloxacin. Given the size of the hernia, surgical repair would have involved multiple sequential procedures with a high risk of intraoperative death. The patient declined surgical intervention.
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