An inguinal hernia occurs when abdominal or pelvic contents protrude through a dilated internal ring or attenuated inguinal floor in the inguinal canal.
Presents with visible or easily palpable swelling in the groin, often with discomfort during strenuous exercise or heavy lifting.
Complications are rare but include incarceration, bowel obstruction, and strangulation.
Diagnosis is usually clinical; imaging may be helpful where there is doubt about diagnosis, but also identifies many clinically insignificant apparent hernias.
Surgical repair remains the mainstay of therapy, although watchful waiting is reasonable in adults with minimally symptomatic or asymptomatic inguinal hernia.
An inguinal hernia is a protrusion of abdominal or pelvic contents through a dilated internal inguinal ring or attenuated inguinal floor into the inguinal canal and usually, but not always, out of the external inguinal ring, causing a visible or easily palpable bulge.
History and exam
Key diagnostic factors
- groin discomfort or pain with bulge
- groin mass
- abdominal discomfort or pain
Other diagnostic factors
- acute abdomen
- nausea and vomiting
- male sex
- older age
- family history
- abdominal aortic aneurysm (AAA)
- defective transversalis fascia
- chronic bronchitis or emphysema
- Marfan syndrome
- Ehlers-Danlos syndrome
- heavy lifting
- benign prostatic hypertrophy
- urethral stricture
1st investigations to order
- clinical diagnosis
Investigations to consider
- ultrasound scan of groin
- CT scan
- MRI of groin
incarcerated or strangulated hernia
small, asymptomatic hernia
large or symptomatic uncomplicated hernia
- Undescended testis
- Femoral hernia
- ACR appropriateness criteria: hernia
- International guidelines for groin hernia management
Inguinal hernia: what is it?
Inguinal hernia: hernia surgeryMore Patient leaflets
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