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Hernia

How do doctors diagnose a hernia?

If you have an inguinal hernia, you can probably see or feel a bulge or swelling in your groin. Doctors can usually diagnose a hernia by examining your groin. But you may also need an ultrasound or X-ray.

To diagnose a hernia, your doctor will probably:

Source:
Scott DJ, Jones DB.
Hernias and abdominal wall defects.
In: Norton JA, Barie PS, Bollinger RR, et al (editors). Surgery: basic science and clinical evidence. Springer, New York, U.S.A.; 2000.

Ask about your symptoms. You may be asked if your groin is painful, how long you've had your symptoms and whether they are worse when you stand up or strain your muscles
Feel your abdomen and groin. You'll need to take off some of your clothes and probably your underwear. While you're standing up, your doctor will gently press your groin to feel the bulge or painful area. You may need to cough to see if a bulge appears when you strain your stomach muscles. Your doctor might also want to examine your groin again while you lie on your back
Examine you internally: If you're a man, your doctor may put a finger against your scrotum and press gently into an opening in your abdominal muscles (called the inguinal canal). If you have a hernia, it will bulge onto the doctor's fingertip when you cough. If you're a woman, your doctor may put a finger just inside your vagina to see if there's a bulge there.

Your doctor should check both sides of your groin for hernias.

Source:
O'Rourke A, Zell JA, Varkey-Zell TT, et al.
Laparoscopic diagnosis and repair of asymptomatic bilateral inguinal hernias.
American Journal of Surgery. 2002; 183: 15-19.

Most people don't need any more tests. However, your doctor may recommend an ultrasound if:

Source:
Deveney KE.
Hernias and other lesions of the abdominal wall.
In: Way LW, Doherty GM (editors). Current surgical diagnosis and treatment. McGraw-Hill, New York, U.S.A.; 2003.

You have a soft swelling in your groin, but your doctor isn't sure that it's a hernia
Your groin is painful but your doctor can't feel a bulge.

An ultrasound is a reliable way to check for hernias.

Source:
Kingsnorth A, Le Blanc K.
Management of abdominal hernias.
3rd edition. Arnold, London, UK; 2003.

⁴

Source:
Bradley M, Morgan D, Pentlow B, et al.
The groin hernia: an ultrasound diagnosis?
Annals of the Royal College of Surgeons of England. 2003; 85: 178-180.

⁵ It shows where and how big the gap in your muscles is. And it shows the contents of the hernia. An ultrasound can also be useful if there might be another problem that's causing the pain or swelling in your groin.

Occasionally doctors recommend other scans, such as

MRI scan
The magnetic resonance imaging (MRI) machine uses a magnetic field to create detailed pictures of the inside of the body. These pictures allow doctors to look at parts of the body in three-dimensional images.

MRI and

CT scan
A CT scan is a type of X-ray. It takes several detailed pictures of the inside of your body from different angles. CT stands for computed tomography. It's also called a CAT scan (computed axial tomography).

CT scans.

Sources for the information on this page:

Scott DJ, Jones DB.Hernias and abdominal wall defects.In: Norton JA, Barie PS, Bollinger RR, et al (editors). Surgery: basic science and clinical evidence. Springer, New York, U.S.A.; 2000.

O'Rourke A, Zell JA, Varkey-Zell TT, et al.Laparoscopic diagnosis and repair of asymptomatic bilateral inguinal hernias.American Journal of Surgery. 2002; 183: 15-19.

Deveney KE.Hernias and other lesions of the abdominal wall.In: Way LW, Doherty GM (editors). Current surgical diagnosis and treatment. McGraw-Hill, New York, U.S.A.; 2003.

Kingsnorth A, Le Blanc K.Management of abdominal hernias.3rd edition. Arnold, London, UK; 2003.

Bradley M, Morgan D, Pentlow B, et al.The groin hernia: an ultrasound diagnosis?Annals of the Royal College of Surgeons of England. 2003; 85: 178-180.

This information was last updated on Jan 09, 2009

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment.
© BMJ Publishing Group Limited 2009. All rights reserved.

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