Inguinal hernia
Diagram of an indirect, scrotal inguinal hernia ( median view from the left).
Pronunciation	/ˈɪŋɡwɪnəl ˈhɜːrniə/
Specialty	General surgery
Symptoms	Pain, bulging in the groin [1]
Complications	Strangulation [1]
Usual onset	< 1 year old, > 50 years old [2]
Risk factors	Family history, smoking, chronic obstructive pulmonary disease, obesity, pregnancy, peritoneal dialysis, collagen vascular disease, previous open appendectomy [1] [2] [3]
Diagnostic method	Based on symptoms, medical imaging [1]
Treatment	Conservative, surgery [1]
Frequency	27% (males), 3% (females) [1]
Deaths	59,800 (2015) [4]

An inguinal hernia is a hernia (protrusion) of abdominal-cavity contents through the inguinal canal. ^[1] Symptoms are present in about 66% of affected people. ^[1] This may include pain or discomfort especially with coughing, exercise, or bowel movements. ^[1] Often it gets worse throughout the day and improves when lying down. ^[1] A bulging area may occur that becomes larger when bearing down. ^[1] Inguinal hernias occur more often on the right than left side. ^[1] The main concern is strangulation, where the blood supply to part of the intestine is blocked. ^[1] This usually produces severe pain and tenderness of the area. ^[1]

Risk factors include smoking, chronic obstructive pulmonary disease, obesity, pregnancy, peritoneal dialysis, collagen vascular disease, and previous open appendectomy. ^{[1] [2]} Hernias are partly genetic and occur more often in certain families. ^[1] It is unclear if inguinal hernias are associated with heavy lifting. ^[1] Hernias can often be diagnosed based on symptoms. ^[1] Occasionally medical imaging is used to confirm the diagnosis or rule out other possible causes. ^[1]

Groin hernias that do not cause symptoms in males do not need to be repaired. ^[1] Repair, however, is generally recommended in females due to the higher rate of femoral hernias which have more complications. ^[1] If strangulation occurs immediate surgery is required. ^[1] Repair may be done by open surgery or laparoscopic surgery. ^[1] Open surgery has the benefit of possibly being done under local anesthesia rather than general anesthesia. ^[1] Laparoscopic surgery generally has less pain following the procedure. ^{[1] [5]}

In 2015 inguinal, femoral, and abdominal hernias affected about 18.5 million people. ^[6] About 27% of males and 3% of females develop a groin hernia at some time in their life. ^[1] Groin hernias occur most often before the age of one and after the age of fifty. ^[2] Globally, inguinal, femoral and abdominal hernias resulted in 60,000 deaths in 2015 and 55,000 in 1990. ^{[4] [7]}

References