Inguinal Hernia

Inguinal hernia

Blog Written by Dr Hyreim Suh

Irreducible Inguinal Hernia 

Definition of an inguinal hernia 

• Protrusion of abdominal or pelvic contents through an inguinal ring or inguinal floor into the inguinal canal 

Diagnosis 

• Diagnosis normally made clinically 
• However, investigations to consider include ultrasound, CT or MRI (for occult hernias) 

Treatment algorithm a hernia 

• Strangulated hernia 
  • Urgent surgical repair, normally open 
  • Mesh repair is indicated if the bowel is viable, but if the bowel was resected mesh should not be used 
  • Supportive management includes fluid resuscitation, insertion of a nasogastric tube, IDC insertion for accurate fluid balance
• Asymptomatic hernia 
  • Monitoring until the hernia becomes symptomatic and warrants surgical repair 
• Symptomatic or large hernia 
  • Open or laparoscopic elective hernia repair if the patient is an appropriate surgical candidate 

References 

Inguinal hernia in adults, BMJ practice, https://bestpractice.bmj.com.acs.hcn.com.au/topics/en-gb/723