Inguinal Hernia
What is it: An indirect inguinal hernia occurs when the processus vaginalis does not obliterate in infancy and abdominal contents invaginate through this patent sac. A direct inguinal hernia occurs when abdominal contents herniate through a weak point in the fascia of the abdominal wall and into the inguinal canal.
How does it present: Patients may present with vague groin pain with activities and those with reducible hernias may note a bulge in the groin or scrotum that increases with Valsalva maneuvers and reduces when lying supine.
Common exam findings: Palpable hernia. Strangulated hernias may present with scrotal edema or erythema of skin overlying the hernia.
Tests and treatment: If a hernia is seen on physical exam, no further imaging studies are needed and the patient should be referred for surgical correction. While awaiting surgical repair, patients should avoid activities that increase intra-abdominal pressure. Strangulated hernias are an emergency and require urgent surgical consultation and management.