Summary
Definition
History and exam
Key diagnostic factors
- desconforto ou dor com abaulamento da virilha
- massa na virilha
- desconforto ou dor abdominal
Other diagnostic factors
- abdome agudo
- náuseas e vômitos
- constipação
Risk factors
- sexo masculino
- idade avançada
- história familiar
- prematuridade
- aneurisma da aorta abdominal (AAA)
- fáscia transversal defeituosa
- bronquite crônica ou enfisema
- Síndrome de Marfan
- Síndrome de Ehlers-Danlos
- latirismo
- tabagismo
- levantamento de peso
- gestação
- ascite
- prostatectomia
- apendicectomia
- hiperplasia prostática benigna
- estenose uretral
Diagnostic investigations
1st investigations to order
- diagnóstico clínico
Investigations to consider
- ultrassonografia da virilha
- Tomografia computadorizada (TC)
- ressonância nuclear magnética (RNM) da virilha
Treatment algorithm
hérnia encarcerada ou estrangulada
hérnia pequena e assintomática
hérnia não complicada grande ou sintomática
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.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Itani KMF, Fitzgibbons R. Approach to groin hernias. JAMA Surg. 2019 Jun 1;154(6):551-2.Full text Abstract
Fitzgibbons RJ Jr, Ramanan B, Arya S, et al. Long-term results of a randomized controlled trial of a nonoperative strategy (watchful waiting) for men with minimally symptomatic inguinal hernias. Ann Surg. 2013 Sep;258(3):508-15. Abstract
Montgomery J, Dimick JB, Telem DA. Management of groin hernias in adults-2018. JAMA. 2018 Sep 11;320(10):1029-30. Abstract
Neumayer L, Giobbie-Hurder A, Jonasson O, et al. Open mesh versus laparoscopic mesh repair of inguinal hernia. N Engl J Med. 2004 Apr 29;350(18):1819-27.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Testículo não descido
- Linfadenopatia
- Hérnia femoral
More DifferentialsGuidelines
- ACR appropriateness criteria: hernia
- International guidelines for groin hernia management
More GuidelinesPatient information
Hérnia inguinal: o que é?
Hérnia inguinal: cirurgia de hérnia
More Patient information
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