Inguinal hernia in adults

Last reviewed: 25 Aug 2022
Last updated: 29 Jun 2022

Summary

Definition

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

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

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  • 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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