Overview:
- It is bulging in inguinal area and may sometimes reach the scrotum in males
- It increases when coughing or doing intense muscle exertion
- May be unilateral or bilateral
Etiology:
- Protrusion of abdominal contents (peritoneal membrane, abdominal fat, intestine) through a weakness in the abdominal wall muscles in the groin
- The weak area of the inguinal canal is usually the site of passaging spermatic cord to scrotum in males or the ligament supporting uterus in females.
Symptoms:
- Swelling of the side of pubic bone increases when standing up or coughing
- pain: ranging from discomfort to a feeling of heaviness or tension to severe pain
- bulging of scrotum in males in the inguinal hernia that reaches the testicle
- An incarcerated inguinal hernia happens when tissue becomes stuck in the groin and isn’t reducible.
This means it can’t be pushed back into place.
- Strangulated inguinal hernias are a more serious medical condition.
This is when an intestine in an incarcerated hernia has its blood flow cut off
Symptoms of strangulated hernia:
- severe pain
- fever
- rough, swollen, reddish bulging
- nausea or vomiting
- inability to defecate or pass gases
(Visit emergency department immediately when these symptoms appear)
Causes:
Risk factors of inguinal hernia are:
- Gender: 8 times more common in males, making up 5% of male newborns
- Age: leading to muscle weakness
- Ethnic group: common in white people
- Genetic predisposition
- Chronic cough as a result of smoking and respiratory diseases
- Chronic constipation
- Pregnancy
- Stressful physical activity
Diagnosis:
- Careful clinical examination
- ultrasound examination to confirm the diagnosis
- CT abdomen for muscle evaluation in confused cases
Treatment:
Abdominal wall hernias, including inguinal hernias, cannot improve over time and cannot be treated medicinally,
so, surgery is the treatment of choice
- laparoscopic surgery with a mesh: where the abdomen is insufflated with Gas (CO2), endoscope and surgical instruments are inserted through small holes in the abdominal wall, release the hernial sack away from muscles of abdominal wall, then close defect in muscles and support it with a mesh.
- open surgery in limited cases.
