Inguinal hernia in adults

Last reviewed: 26 Aug 2023
Last updated: 29 Jun 2022



History and exam

Key diagnostic factors

  • groin discomfort or pain with bulge
  • groin mass
  • abdominal discomfort or pain
More key diagnostic factors

Other diagnostic factors

  • acute abdomen
  • nausea and vomiting
  • constipation
Other diagnostic factors

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
More risk factors

Diagnostic investigations

1st investigations to order

  • clinical diagnosis
More 1st investigations to order

Investigations to consider

  • ultrasound scan of groin
  • CT scan
  • MRI of groin
More investigations to consider

Treatment algorithm


incarcerated or strangulated hernia


small, asymptomatic hernia

large or symptomatic uncomplicated hernia



Richard Burney, MD

Professor Emeritus of Surgery

Section of General Surgery

University of Michigan

Ann Arbor



RB declares that he has no competing interests.


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




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




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 leaflets

    Inguinal hernia: what is it?

    Inguinal hernia: hernia surgery

    More Patient leaflets
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