When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Inguinal hernia in adults

Last reviewed: 3 Nov 2024
Last updated: 02 Oct 2024

Summary

Definition

History and exam

Key diagnostic factors

  • groin discomfort or pain with bulge
  • groin mass
  • abdominal discomfort or pain
Full details

Other diagnostic factors

  • acute abdomen
  • nausea and vomiting
  • constipation
Full details

Risk factors

  • male sex
  • older age
  • family history
  • prematurity
  • abdominal aortic aneurysm (AAA)
  • defective transversalis fascia
  • chronic bronchitis or emphysema
  • Marfan syndrome
  • Ehlers-Danlos syndrome
  • lathyrism
  • smoking
  • heavy lifting
  • pregnancy
  • ascites
  • prostatectomy
  • appendectomy
  • benign prostatic hypertrophy
  • urethral stricture
Full details

Diagnostic tests

1st tests to order

  • clinical diagnosis
Full details

Tests to consider

  • ultrasound scan of groin
  • CT scan
  • MRI of groin
Full details

Treatment algorithm

ACUTE

incarcerated or strangulated hernia

ONGOING

small, asymptomatic hernia

large or symptomatic uncomplicated hernia

Contributors

Authors

Richard Burney, MD

Professor Emeritus of Surgery

Section of General Surgery

University of Michigan

Ann Arbor

MI

Disclosures

RB declares that he has no competing interests.

Acknowledgements

Dr Richard Burney would like to gratefully acknowledge Dr LS Wong and Dr EA Agaba, the previous contributors to this monograph. LSW and EAA declare that they have no competing interests.

Peer reviewers

Mark Carlson, MD, FACS

Department of Surgery

University of Nebraska Medical Center

Omaha

NE

Disclosures

MC declares that he has no competing interests.

Patrick J. O'Dwyer, MBChB BAO, FRCS, MCh

Professor of Gastrointestinal Surgery

University Department of Surgery

Western Infirmary

Glasgow

UK

Disclosures

PJOD declares that he has no competing interests.

  • Differentials

    • Undescended testis
    • Lymphadenopathy
    • Femoral hernia
    More Differentials
  • Guidelines

    • ACR appropriateness criteria: hernia
    • International guidelines for groin hernia management
    More Guidelines
  • Patient information

    Inguinal hernia: what is it?

    Inguinal hernia: hernia surgery

    More Patient information
  • padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer