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A physician may diagnose an inguinal hernia, as well as the type, from medical history and physical examination. [20] For confirmation or in uncertain cases, medical ultrasonography is the first choice of imaging, because it can both detect the hernia and evaluate its changes with for example pressure, standing and Valsalva maneuver .
Inguinal hernia can make a small lump in the groin region which can be detected during a physical exam and verified by imaging techniques such as computed tomography (CT). This lump can disappear by lying down and reappear through physical activities, laughing, crying, or forceful bowel movement.
Unlike hernias in adults, these hernias involve the failure of the peritoneum, the sac that encloses the intestines, to close properly, resulting in an opening between the abdomen and scrotum. Detecting an inguinal hernia is typically characterized by a noticeable bulge in the groin or scrotum, which may vary in size.
In medicine, Carnett's sign is a finding on clinical examination in which abdominal pain remains unchanged or increases when the muscles of the abdominal wall are tensed. [1] [2] For this part of the abdominal examination, the patient can be asked to lift the head and shoulders from the examination table to tense the abdominal muscles.
An indirect inguinal hernia and a direct inguinal hernia can be distinguished by their positioning in relation to the inferior epigastric vessels. An indirect hernia is situated laterally to these vessels, whereas a direct hernia is positioned medially to them. Inguinal hernias are the most common type of hernia in both men and women.
The inguinal ligament attaches to it. [1] Part of the abdominal external oblique muscle inserts onto it. [1] The inferior epigastric artery passes between the pubic tubercle and the anterior superior iliac spine. [2] The pubic spine is a rough ridge that extends from the pubic tubercle to the upper border of the pubic symphysis.
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Post herniorrhaphy pain syndrome, or inguinodynia is pain or discomfort lasting greater than 3 months after surgery of inguinal hernia. Randomized trials of laparoscopic vs open inguinal hernia repair have demonstrated similar recurrence rates with the use of mesh and have identified that chronic groin pain (>10%) surpasses recurrence (<2%) and is an important measure of success.
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