What is an inguinal hernia?
A hernia occurs when a section of intestine protrudes through a weakness or gap in the abdominal wall. An inguinal hernia occurs in the groin area, where a section of intestine pushes through a weak spot in the inguinal canal — a triangle-shaped opening between layers of abdominal muscle near the groin.
Inguinal Hernia Causes
As a male fetus grows and matures during pregnancy, the testicles develop in the abdomen and then move down into the scrotum through the area called the inguinal canal. Shortly after birth, the inguinal canal closes, preventing the testicles from moving back into the abdomen. If this area does not close completely, a loop of intestine can move into the inguinal canal through the weakened area of the lower abdominal wall, causing a hernia.
Women also have an inguinal canal. Inguinal hernias are the most common type of hernia that women develop.
Inguinal hernias can also be caused by any of the following:
- Heavy lifting
- Straining during bowel movement
Inguinal Hernia Diagnosis
To identify an inguinal hernia, a health care provider may use multiple diagnostic techniques but will begin with a medical history and physical examination looking for symptoms such as:
- Constipation, “narrow” or “thin” stool
- Lump or protrusion in the groin or scrotum; the patient may be asked to stand and cough, allowing the provider to feel the hernia as it moves into the groin or scrotum
- Nausea, vomiting, fever or rapid heart rate
- Pressure, pain or swelling in the groin or scrotum
- Warm lump or protrusion that has turned red, purple or dark
If the protruding portion of intestine has become trapped (strangulated) within the abdominal wall, the blood supply to the intestine can get cut off, causing further complications such as necrosis (tissue death). If your provider suspects this is the case, additional diagnostics may include:
- Blood tests to look for infections caused by intestinal blockage or necrosis
- Ultrasound, MRI, CT or other imaging to check for blockage or actual location of the intestinal protrusion
Inguinal Hernia Treatments
Specific treatment for an inguinal hernia will be determined by your surgeon based on multiple factors such as your general health, anatomy, extent and location of the hernia, and desired level of future physical activity. Ultimately, treatment will consist of one of two types of surgeries:
Open hernia repair
In this surgical procedure, also known as herniorrhaphy, the surgeon makes an incision in the groin, pushes any protruding intestine back into the abdomen and repairs the opening in the muscle wall. Sometimes, in a procedure known as hernioplasty, the weak area is repaired and reinforced with steel mesh or wire.
In this minimally invasive surgical procedure, the surgeon makes several small incisions in the lower abdomen and first inserts a tubelike instrument, called a laparoscope, equipped with a camera into one of the incisions. The internal images are displayed on a large monitor that the surgeon uses to guide small instruments inserted through the other incisions to repair the hernia.