Inguinal hernia is a type of abdominal wall hernia 1.
They are the commonest type of abdominal wall herniation (up to 80% 3) and are most often acquired. There is a recognized male predilection with an M:F ratio of up to 7:1 3.
Patients most commonly present with swelling and/or pain in the relevant groin, iliac fossa, loin. Men may also have testicular pain.
It is broadly divided into two types:
- indirect inguinal hernia
- direct inguinal hernia
All of the following confer an increased risk for indirect inguinal hernia:
- prematurity and low birth weight 9
- patent processus vaginalis
- urologic conditions (e.g. cryptorchidism, hypospadias or epispadias, bladder exstrophy, ambiguous genitalia)
- abdominal wall defects (omphalocele, gastroschisis, cloacal exstrophy, bladder exstrophy)
- family history
A direct inguinal hernia is a consequence of weakened abdominal musculature, often brought on by
- advanced age
- previous abdominal surgery
While inguinal hernias, in general, are much more common in males than in females, direct hernias, in particular, are rare in women since the broad ligament acts as an additional barrier.
Treatment and prognosis
Surgical treatment options include
Complications, as in any other abdominal wall herniation, include:
Compared with other types of abdominal wall hernias, the incidence of complications is considered lower 3.
Possible imaging differential considerations include
- 1. Zarvan NP, Lee FT, Yandow DR et-al. Abdominal hernias: CT findings. AJR Am J Roentgenol. 1995;164 (6): 1391-5. AJR Am J Roentgenol (abstract) - Pubmed citation
- 2. Jamadar DA, Jacobson JA, Morag Y et-al. Sonography of inguinal region hernias. AJR Am J Roentgenol. 2006;187 (1): 185-90. doi:10.2214/AJR.05.1813 - Pubmed citation
- 3. Suzuki S, Furui S, Okinaga K et-al. Differentiation of femoral versus inguinal hernia: CT findings. AJR Am J Roentgenol. 2007;189 (2): W78-83. doi:10.2214/AJR.07.2085 - Pubmed citation
- 4. Van den berg JC, De valois JC, Go PM et-al. Radiological anatomy of the groin region. Eur Radiol. 2000;10 (4): 661-70. Eur Radiol (link) - Pubmed citation
- 5. Van den berg JC. Inguinal hernias: MRI and ultrasound. Semin. Ultrasound CT MR. 2002;23 (2): 156-73. - Pubmed citation
- 6. Shadbolt CL, Heinze SB, Dietrich RB. Imaging of groin masses: inguinal anatomy and pathologic conditions revisited. Radiographics. 2001;21 Spec No : S261-71. Radiographics (link) - Pubmed citation
- 7. Zafar HM, Levine MS, Rubesin SE et-al. Anterior abdominal wall hernias: findings in barium studies. Radiographics. 26 (3): 691-9. doi:10.1148/rg.263055714 - Pubmed citation
- 8. Lee GH, Cohen AJ. CT imaging of abdominal hernias. AJR Am J Roentgenol. 1993;161 (6): 1209-13. AJR Am J Roentgenol (abstract) - Pubmed citation
- 9. Kumar VH, Clive J, Rosenkrantz TS et-al. Inguinal hernia in preterm infants (< or = 32-week gestation). Pediatr. Surg. Int. 2002;18 (2-3): 147-52. doi:10.1007/s003830100631 - Pubmed citation
- 10. Brunicardi F, Andersen D, Billiar T et-al. Schwartz's Principles of Surgery, 10th edition. McGraw-Hill Professional. ISBN:0071796754. Read it at Google Books - Find it at Amazon