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Inguinal Hernia

By Parswa Ansari, MD

An inguinal hernia is a protrusion of a piece of intestine through an opening in the abdominal wall in the groin.

  • People have a painless bulge in the groin or scrotum.

  • Computed tomography or ultrasonography can be used for diagnosis.

  • Surgery is done if hernias are in women, cause symptoms, or become strangulated or incarcerated.

What Is an Inguinal Hernia?

In an inguinal hernia, a loop of intestine pushes through an opening in the abdominal wall into the inguinal canal. The inguinal canal contains the spermatic cord, which consists of the vas deferens, blood vessels, nerves, and other structures. Before birth, the testes, which are formed in the abdomen, pass through the inguinal canal as they descend into the scrotum.

An inguinal hernia extends into the groin and can extend into the scrotum. Other types of hernias (such as umbilical hernias and femoral hernias) occur at other locations. With an inguinal hernia, the opening in the abdominal wall can be present from birth or develop later in life.

Symptoms

Inguinal hernias usually cause a painless bulge in the groin or scrotum. The bulge may enlarge when men stand and shrink when they lie down because the intestine slides back and forth with gravity. Sometimes a portion of the intestine is trapped in the scrotum (incarceration). If the intestine becomes trapped, the intestine’s blood supply can be cut off (strangulation). Strangulated intestine may die (become gangrenous) within hours.

Diagnosis

  • A doctor's examination

  • Sometimes imaging tests

The doctor bases the diagnosis of inguinal hernia on an examination. While the person is standing, the doctor examines the groin and asks the person to cough. Coughing increases pressure in the abdominal cavity. If the person has an inguinal hernia, coughing will cause the hernia to bulge outward, making it easier for the doctor to detect. In addition, in men, the doctor places a finger into a fold on the upper part of the scrotum and pushes upward toward the abdominal cavity to detect a hernia.

Sometimes the doctor does ultrasonography or computed tomography (CT) to help make the diagnosis.

Treatment

  • Surgical repair

Inguinal hernias in women and those that cause symptoms in men should be surgically repaired. In men who have an inguinal hernia that does not cause any symptoms, surgery does not need to be done unless symptoms develop. Surgery can be done at a time convenient for the person.

For strangulated and incarcerated hernias, emergency surgery is needed to pull the intestine out of the inguinal canal.

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* This is the Consumer Version. *