Ultrasonography of inguinal hernia

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Author: Mikael Häggström [notes 1]

Planning

In Swedish practice, an inguinal bulge is evaluated within 2 months unless there's significant pain.[notes 2]

In strong abdominal pain, a suspected strangulated hernia indicates surgery without previous ultrasound, whereas an unclear diagnosis indicates abdominal CT.

Evaluation

File:Ultrasonography of inguinal hernia (annotated).jpg
Ultrasound of an indirect hernia containing fat, with testicle seen at right.

Without and with Valsalva maneuver.[1] Preferably also in standing.[1]

Further workup

If an inguinal hernia is detected:

  • Size with and without provocation (Valsalva maneuver and/or standing)
  • Content, merely fat, or also intestines
  • Ability to reduce by pressure

If the hernia is not clearly within the inguinal canal, check if it lies medially to the inferior epigastric vessels, since it is then classified as a direct hernia.

Notes

  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.
  2. NU Hospital Group, Sweden

References

  1. 1.0 1.1 Jamadar, David A.; Jacobson, Jon A.; Morag, Yoav; Girish, Gandikota; Ebrahim, Farhad; Gest, Thomas; Franz, Michael (2006). "Sonography of Inguinal Region Hernias ". American Journal of Roentgenology 187 (1): 185–190. doi:10.2214/AJR.05.1813. ISSN 0361-803X.