What is an inguinal
An inguinal hernia occurs in the abdomen near the groin area. They develop when fatty or intestinal tissues push through a weakness in the abdominal wall near the right or left inguinal canal. Each inguinal canal resides at the base of the abdomen.
Both men and woman have inguinal canals. In men, the testes usually descend through their canal by around a few weeks before birth. In women, each canal is the location of passage for the round ligament of the uterus. If you have a hernia in or near this passageway, it results in a protruding bulge. It may be painful during movement.
Many people don’t seek treatment for this type of hernia because it may be small or not cause any symptoms. Prompt medical treatment can help prevent further protrusion and discomfort.
of inguinal hernia
of inguinal hernia
Inguinal hernias are most noticeable by their appearance. They cause bulges along the pubic or groin area that can appear to increase in size when you stand up or cough. This type of hernia may be painful or sensitive to the touch.
Other symptoms may include:
- pain when coughing, exercising, or bending over
- burning sensations
- sharp pain
- a heavy or full sensation in the groin
- swelling of the scrotum in men
and risk factors of inguinal hernia
and risk factors of inguinal hernia
There isn’t one cause for this type of hernia. However, weak spots within the abdominal and groin muscles are thought to be a major contributor. Extra pressure on this area of the body can eventually cause a hernia.
Some risk factors can increase your chances of this condition. These include:
- having a prior inguinal hernia
- being male
- premature birth
- being overweight or obese
- cystic fibrosis
- chronic cough
- chronic constipation
of inguinal hernias
of inguinal hernias
Inguinal hernias can be indirect or direct , incarcerated, or strangulated .
Indirect inguinal hernia
An indirect inguinal hernia is the most common type. It often occurs in premature births, before the inguinal canal becomes closed off. However, this type of hernia can occur at any time during your life. This condition is most common in males.
Direct inguinal hernia
A direct inguinal hernia most often occurs in adults as they age. The popular belief is that weakening muscles during adulthood lead to a direct inguinal hernia. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) , this type of hernia is much more prevalent in men.
Incarcerated inguinal hernia
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 hernia
Strangulated inguinal hernias are a more serious medical condition. This is when intestine in an incarcerated hernia has its blood flow cut off. Strangulated hernias are life-threatening and require emergency medical care.
an inguinal hernia
an inguinal hernia
Your doctor can usually diagnose an inguinal hernia during a physical exam. During the exam, your doctor will ask you to cough while standing so they can check the hernia when it’s most noticeable.
When it’s reducible, you or your doctor should be able to easily push an inguinal hernia back into your abdomen when you’re lying down on your back. However, if this is unsuccessful, you may have an incarcerated or strangulated inguinal hernia.
Surgery is the primary treatment for inguinal hernias. It’s a very common operation and a highly successful procedure when done by a well-trained surgeon.
Options include either an open inguinal herniorrhaphy or laparoscopic inguinal herniorrhaphy. In open inguinal herniorrhaphy , one larger incision is made over the abdomen near the groin. In laparoscopic inguinal herniorrhaphy, multiple smaller abdominal incisions are made. A long, thin tube with a lighted camera on the end helps the surgeon see inside your body to perform the surgery.
The goal of either surgical approach is returning the internal abdominal tissue(s) back into the abdominal cavity and repairing the abdominal wall defect. Mesh is commonly placed to reinforce the abdominal wall. Once structures are put into their proper place, your surgeon will close the opening with sutures, staples, or adhesive glue.
There are potential pros and cons to open inguinal hernia repair versus laparoscopic. For instance, laparoscopic herniorrhaphy may be preferable if you want a shorter recovery time. But your risk of hernia recurrence may be greater with laparoscopic repair.
Prevention and outlook of inguinal hernias
Although you can’t prevent genetic risk factors, it’s possible to reduce your risk of occurrence or the severity of abdominal hernias. Follow these tips:
- Maintain a healthy weight .
- Eat a high-fiber diet .
- Quit smoking cigarettes.
- Avoid heavy lifting.
Early surgical treatment can help cure inguinal hernias. However, there’s always the slight risk of recurrence and complications. These can include infection after surgery or poor surgical wound healing. Call your doctor if you experience new symptoms or if side effects occur after treatment.
- Inguinal Hernia Repair
- 22 High-Fiber Foods You Should Eat
- What Is a Strangulated Hernia?
- Femoral Hernia
READ THIS NEXT
A hernia occurs when an organ pushes through the muscle or tissue that holds it in place. Read on to learn about its causes and treatments.
- Inguinal Hernia Repair
Inguinal hernia occurs when part of the small intestine protrudes through the groin. Here are your options for repair and what to expect during…
- 22 High-Fiber Foods You Should Eat
Eating plenty of fiber has numerous health benefits. Here are 22 healthy high-fiber foods that can help you lose weight and reduce your risk of…
- What Is a Strangulated Hernia?
A strangulated hernia is a medical emergency. Find out the symptoms and how it's treated.
- Femoral Hernia
A femoral hernia will appear as a bulge near the groin or thigh. We'll teach you about causes, severe symptoms that mean you should call 911, and…
- What You Should Know About Direct versus Indirect Hernias
If you've been diagnosed with a hernia, your doctor will tell you if it's direct or indirect. Learn more about these two types of hernias.
Learn about the herniorrhaphy surgery procedure, including how long it takes to recover.
Laparoscopy is used to examine the abdominal organs. We'll teach you how to prepare, what to expect during the procedure, and how long it takes to…
- 15 Tips for Quitting Smoking
It's no secret that smoking has negative effects on your health. But that doesn't make it easy to quit. Our readers sent us their tips on how to quit…
- Exercise and Weight Loss
One method that can help a person lose weight is to limit the number of calories taken in through their diet and burn extra calories through exercise.
CMS Id: 21944
Client Version: 7f032385b4aae54fea3461a2afc51d9c59c8354f
Build Number: 20012
Jump to navigation
Jump to search
|Diagram of an indirect , scrotal inguinal hernia ( median view from the left).|
|Symptoms||Pain, bulging in the groin |
|Usual onset||< 1 year old, > 50 years old |
|Risk factors||Family history , smoking, chronic obstructive pulmonary disease , obesity , pregnancy , peritoneal dialysis , collagen vascular disease , previous open appendectomy   |
|Diagnostic method||Based on symptoms, medical imaging |
|Treatment||Conservative , surgery |
|Frequency||27% (males), 3% (females) |
|Deaths||59,800 (2015) |
An inguinal hernia is a protrusion of abdominal-cavity contents through the inguinal canal .  Symptoms are present in about 66% of affected people.  This may include pain or discomfort especially with coughing, exercise, or bowel movements.  Often it gets worse throughout the day and improves when lying down.  A bulging area may occur that becomes larger when bearing down.  Inguinal hernias occur more often on the right than left side.  The main concern is strangulation, where the blood supply to part of the intestine is blocked.  This usually produces severe pain and tenderness of the area. 
Risk factors for the development of a hernia include: smoking , chronic obstructive pulmonary disease , obesity , pregnancy , peritoneal dialysis , collagen vascular disease , and previous open appendectomy , among others.   Hernias are partly genetic and occur more often in certain families.  It is unclear if inguinal hernias are associated with heavy lifting.  Hernias can often be diagnosed based on signs and symptoms.  Occasionally medical imaging is used to confirm the diagnosis or rule out other possible causes. 
Groin hernias that do not cause symptoms in males do not need to be repaired.  Repair, however, is generally recommended in females due to the higher rate of femoral hernias which have more complications.  If strangulation occurs immediate surgery is required.  Repair may be done by open surgery or by laparoscopic surgery .  Open surgery has the benefit of possibly being done under local anesthesia rather than general anesthesia .  Laparoscopic surgery generally has less pain following the procedure.  
In 2015 inguinal, femoral and abdominal hernias affected about 18.5 million people.  About 27% of males and 3% of females develop a groin hernia at some time in their life.  Groin hernias occur most often before the age of one and after the age of fifty.  Globally, inguinal, femoral and abdominal hernias resulted in 60,000 deaths in 2015 and 55,000 in 1990.  
- 1 Signs and symptoms
- 2 Pathophysiology
- 3 Diagnosis
- 3.1 Direct inguinal hernia
- 3.2 Indirect inguinal hernia
- 3.3 Differential diagnosis
- 4 Management
- 4.1 Conservative
- 4.2 Surgical
- 5 Epidemiology
- 6 See also
- 7 References
- 8 External links
Signs and symptoms[ edit ]
Frontal view of an inguinal hernia (right).
Hernias present as bulges in the groin area that can become more prominent when coughing, straining, or standing up. The bulge commonly disappears on lying down. Mild discomfort can develop over time. The inability to “reduce”, or place the bulge back into the abdomen usually means the hernia is ‘incarcerated’ which requires emergency surgery.
Significant pain is suggestive of strangulated bowel (an incarcerated indirect inguinal hernia ).
As the hernia progresses, contents of the abdominal cavity, such as the intestines, can descend into the hernia and run the risk of being pinched within the hernia, causing an intestinal obstruction. If the blood supply of the portion of the intestine caught in the hernia is compromised, the hernia is deemed “strangulated” and gut ischemia and gangrene can result, with potentially fatal consequences. The timing of complications is not predictable.
Pathophysiology[ edit ]
In men, indirect hernias follow the same route as the descending testes , which migrate from the abdomen into the scrotum during the development of the urinary and reproductive organs . The larger size of their inguinal canal , which transmitted the testicle and accommodates the structures of the spermatic cord , might be one reason why men are 25 times more likely to have an inguinal hernia than women. Although several mechanisms such as strength of the posterior wall of the inguinal canal and shutter mechanisms compensating for raised intra-abdominal pressure prevent hernia formation in normal individuals, the exact importance of each factor is still under debate. The physiological school of thought thinks that the risk of hernia is due to a physiological difference between patients who suffer hernia and those who do not, namely the presence of aponeurotic extensions from the transversus abdominis aponeurotic arch. 
Illustration of an inguinal hernia.
Different types of inguinal hernias.
Diagnosis[ edit ]
An incarcerated inguinal hernia as seen on cross sectional CT scan
A frontal view of an incarcerated inguinal hernia (on the patient’s left side) with dilated loops of bowel above.
An inguinal hernia which contains part of the bladder. Bladder cancer also present.
There are two types of inguinal hernia , direct and indirect , which are defined by their relationship to the inferior epigastric vessels . Direct inguinal hernias occur medial to the inferior epigastric vessels when abdominal contents herniate through a weak spot in the fascia of the posterior wall of the inguinal canal, which is formed by the transversalis fascia . Indirect inguinal hernias occur when abdominal contents protrude through the deep inguinal ring , lateral to the inferior epigastric vessels; this may be caused by failure of embryonic closure of the processus vaginalis .
In the case of the female, the opening of the superficial inguinal ring is smaller than that of the male. As a result, the possibility for hernias through the inguinal canal in males is much greater because they have a larger opening and therefore a much weaker wall through which the intestines may protrude.
|Type||Description||Relationship to inferior epigastric vessels||Covered by internal spermatic fascia ?||Usual onset|
|indirect inguinal hernia||protrudes through the inguinal ring and is ultimately the result of the failure of embryonic closure of the processus vaginalis after the testicle passes through it||Lateral||Yes||Congenital / Adult|
|direct inguinal hernia||enters through a weak point in the fascia of the abdominal wall ( Hesselbach triangle )||Medial||No||Adult|
Inguinal hernias, in turn, belong to groin hernias , which also includes femoral hernias . A femoral hernia is not via the inguinal canal, but via the femoral canal , which normally allows passage of the common femoral artery and vein from the pelvis to the leg.
In Amyand’s hernia , the content of the hernial sac is the vermiform appendix .
Ultrasound image of inguinal hernia. Moving intestines in inguinal canal with respiration.
In Littre’s hernia , the content of the hernial sac contains a Meckel’s diverticulum .
Clinical classification of hernia is also important according to which hernia is classified into
- Reducible hernia: is one which can be pushed back into the abdomen by putting manual pressure to it.
- Irreducible/Incarcerated hernia: is one which cannot be pushed back into the abdomen by applying manual pressure.
Irreducible hernias are further classified into
- Obstructed hernia: is one in which the lumen of the herniated part of intestine is obstructed.
- Strangulated hernia: is one in which the blood supply of the hernia contents is cut off, thus, leading to ischemia. The lumen of the intestine may be patent or not.
Direct inguinal hernia[ edit ]
The direct inguinal hernia enters through a weak point in the fascia of the abdominal wall , and its sac is noted to be medial to the inferior epigastric vessels . Direct inguinal hernias may occur in males or females, but males are ten times more likely to get a direct inguinal hernia. 
A direct inguinal hernia protrudes through a weakened area in the transversalis fascia near the medial inguinal fossa within an anatomic region known as the inguinal or Hesselbach’s triangle , an area defined by the edge of the rectus abdominis muscle , the inguinal ligament and the inferior epigastric artery. These hernias are capable of exiting via the superficial inguinal ring and are unable to extend into the scrotum .
When a patient suffers a simultaneous direct and indirect hernia on the same side, the result is called a ” pantaloon ” hernia (because it looks like a pair of pants, with the epigastric vessels in the crotch), and the defects can be repaired separately or together.
Since the abdominal walls weaken with age, direct hernias tend to occur in the middle-aged and elderly. This is in contrast to indirect hernias which can occur at any age including the young, since their etiology includes a congenital component where the inguinal canal is left more patent (compared to individuals less susceptible to indirect hernias).   Additional risk factors include chronic constipation, overweight/obesity, chronic cough, family history and prior episodes of direct inguinal hernias. 
Indirect inguinal hernia[ edit ]
Ultrasound of an indirect hernia containing fat, with testicle seen at right.
T2 weighted MRI of the same case (done for another purpose), also demonstrating fat content.
Ultrasound showing an indirect inguinal hernia 
Incarcerated inguinal hernia 
An indirect inguinal hernia results from the failure of embryonic closure of the deep inguinal ring after the testicle has passed through it. It is the most common cause of groin hernia.
In the male fetus, the peritoneum gives a coat to the testicle as it passes through this ring, forming a temporary connection called the processus vaginalis . In normal development, the processus is obliterated once the testicle is completely descended. The permanent coat of peritoneum that remains around the testicle is called the tunica vaginalis . The testicle remains connected to its blood vessels and the vas deferens, which make up the spermatic cord and descend through the inguinal canal to the scrotum.
The deep inguinal ring, which is the beginning of the inguinal canal, remains as an opening in the fascia transversalis, which forms the fascial inner wall of the spermatic cord. When the opening is larger than necessary for passage of the spermatic cord, the stage is set for an indirect inguinal hernia. The protrusion of peritoneum through the internal inguinal ring can be considered an incomplete obliteration of the processus.
In an indirect inguinal hernia, the protrusion passes through the deep inguinal ring and is located lateral to the inferior epigastric artery. Hence, the conjoint tendon is not weakened.
There are three main types
- Bubonocele: in this case the hernia is limited in inguinal canal.
- Funicular: here the processus vaginalis is closed at its lower end just above the epididymis. The content of the hernial sac can be felt separately from the testis which lies below the hernia.
- Complete (or vaginal): here the processus vaginalis is patent throughout. The hernial sac is continuous with the tunica vaginalis of the testis. The hernia descends down to the bottom of the scrotum and it is difficult to differentiate the testis from hernia.
In the female, groin hernias are only 4% as common as in males. Indirect inguinal hernia is still the most common groin hernia for females. If a woman has an indirect inguinal hernia, her internal inguinal ring is patent, which is abnormal for females. The protrusion of peritoneum is not called “processus vaginalis” in women, as this structure is related to the migration of the testicle to the scrotum. It is simply a hernia sac. The eventual destination of the hernia contents for a woman is the labium majus on the same side, and hernias can enlarge one labium dramatically if they are allowed to progress.
After the diagnosis is suspected, it is often confirmed by imaging. When assessed by ultrasound or cross sectional imaging with CT or MRI , the major differential in diagnosing indirect inguinal hernias is differentiation from spermatic cord lipomas , as both can contain only fat and extend along the inguinal canal into the scrotum. 
On axial CT , lipomas originate posterolateral to the cord, and are located inside the cremaster muscle , while inguinal hernias lie anteromedial to the cord and are not intramuscular. Large lipomas may appear nearly indistinguishable as the fat engulfs anatomic boundaries, but they do not change position with coughing or straining. 
Differential diagnosis[ edit ]
Differential diagnosis of the symptoms of inguinal hernia mainly includes the following potential conditions: 
- Femoral hernia
- Testicular torsion
- Inguinal adenopathy ( Lymph node Swelling)
- Groin abscess
- Saphenous vein dilation, called Saphena varix
- Vascular aneurysm or pseudoaneurysm
- Cryptorchidism ( Undescended testes )
Management[ edit ]
Conservative[ edit ]
There is currently no medical recommendation about how to manage an inguinal hernia condition in adults, due to the fact that, until recently,   elective surgery used to be recommended. The hernia truss is intended to contain a reducible inguinal hernia within the abdomen. It is not considered to provide a cure, and if the pads are hard and intrude into the hernia aperture they may cause scarring and enlargement of the aperture. In addition, most trusses with older designs are not able effectively to contain the hernia at all times, because their pads do not remain permanently in contact with the hernia. The more modern variety of truss is made with non-intrusive flat pads and comes with a guarantee to hold the hernia securely during all activities. Although there is as yet no proof that such devices can prevent an inguinal hernia from progressing, they have been described by users as providing greater confidence and comfort when carrying out physically demanding tasks.[ citation needed ] A truss also increases the probability of complications, which include strangulation of the hernia, atrophy of the spermatic cord, and atrophy of the fascial margins. This allows the defect to enlarge and makes subsequent repair more difficult.  Their popularity is likely to increase, as many individuals with small, painless hernias are now delaying hernia surgery due to the risk of post-herniorrhaphy pain syndrome .  The elasticised pants used by athletes also provide useful support for the smaller hernia.
Surgical[ edit ]
Surgical incision in groin after inguinal hernia operation
Surgical correction of inguinal hernias is called a hernia repair . It is not recommended in minimally symptomatic hernias, for which watchful waiting is advised, due to the risk of post herniorraphy pain syndrome . Surgery is commonly performed as outpatient surgery . There are various surgical strategies which may be considered in the planning of inguinal hernia repair. These include the consideration of mesh use (e.g. synthetic or biologic ), open repair, use of laparoscopy , type of anesthesia (general or local), appropriateness of bilateral repair, etc. Laparoscopy is most commonly used for non-emergency cases, however, a minimally invasive open repair may have a lower incidence of post-operative nausea and mesh associated pain. During surgery conducted under local anaesthesia, the patient will be asked to cough and strain during the procedure to help in demonstrating that the repair is without tension and sound. 
Constipation after hernia repair results in strain to evacuate the bowel causing pain, and fear that the sutures may rupture. Opioid analgesia makes constipation worse. Promoting an easy bowel motion is important post-operatively.
Surgical correction is always recommended for inguinal hernias in children. 
Emergency surgery for incarceration and strangulation carry much higher risk than planned, “elective” procedures. However, the risk of incarceration is low, evaluated at 0.2% per year.  On the other hand, surgery has a risk of inguinodynia (10-12%), and this is why males with minimal symptoms are advised to watchful waiting .   However, if they experience discomfort while doing physical activities or they routinely avoid them for fear of pain, they should seek surgical evaluation.  For female patients, surgery is recommended even for asymptomatic patients. 
Epidemiology[ edit ]
A direct inguinal hernia is less common (~25–30% of inguinal hernias) and usually occurs in men over 40 years of age.
Men have an 8 times higher incidence of inguinal hernia than women. 
See also[ edit ]
- Birkett hernia
References[ edit ]
- ^ a b c d e f g h i j k l m n o p q r s t u v w x y z Fitzgibbons RJ, Jr; Forse, RA (19 February 2015). “Clinical practice. Groin hernias in adults”. The New England Journal of Medicine. 372 (8): 756–63. doi : 10.1056/NEJMcp1404068 . PMID 25693015 .
- ^ a b c d Domino, Frank J. (2014). The 5-minute clinical consult 2014 (22nd ed.). Philadelphia, Pa.: Wolters Kluwer Health/Lippincott Williams & Wilkins. p. 562. ISBN 9781451188509 .
- ^ Burcharth J, Pommergaard HC, Rosenberg J (2013). “The inheritance of groin hernia: a systematic review”. Hernia. 17 (2): 183–9. doi : 10.1007/s10029-013-1060-4 . PMID 23423330 .
- ^ a b GBD 2015 Mortality and Causes of Death, Collaborators. (8 October 2016). “Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015” . Lancet. 388 (10053): 1459–1544. doi : 10.1016/S0140-6736(16)31012-1 . PMC 5388903 . PMID 27733281 .
- ^ Simons MP, Aufenacker T, Bay-Nielsen M, et al. (August 2009). “European Hernia Society guidelines on the treatment of inguinal hernia in adult patients” . Hernia. 13 (4): 343–403. doi : 10.1007/s10029-009-0529-7 . PMC 2719730 . PMID 19636493 .
- ^ GBD 2015 Disease and Injury Incidence and Prevalence, Collaborators. (8 October 2016). “Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015” . Lancet. 388 (10053): 1545–1602. doi : 10.1016/S0140-6736(16)31678-6 . PMC 5055577 . PMID 27733282 .
- ^ GBD 2013 Mortality and Causes of Death, Collaborators (17 December 2014). “Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013” . Lancet. 385 (9963): 117–71. doi : 10.1016/S0140-6736(14)61682-2 . PMC 4340604 . PMID 25530442 .
- ^ Desarda MP (2003). “Surgical physiology of inguinal hernia repair—a study of 200 cases” . BMC Surg. 3: 2. doi : 10.1186/1471-2482-3-2 . PMC 155644 . PMID 12697071 .
- ^ a b “Direct Inguinal Hernia” . University of Connecticut. Retrieved May 6, 2012.
- ^ James Harmon M.D. Lecture 13. Human Gross Anatomy. University of Minnesota. September 4, 2008.
- ^ http://www.emedicinehealth.com/hernia/article_em.htm
- ^ “UOTW #16 – Ultrasound of the Week” . Ultrasound of the Week. 2 September 2014. Retrieved 27 May 2017.
- ^ “UOTW #40 – Ultrasound of the Week” . Ultrasound of the Week. 9 March 2015.
- ^ a b Burkhardt, J. H.; Arshanskiy, Y; Munson, J. L.; Scholz, F. J. (2011). “Diagnosis of inguinal region hernias with axial CT: The lateral crescent sign and other key findings”. RadioGraphics. 31 (2): E1–12. doi : 10.1148/rg.312105129 . PMID 21415178 .
- ^ Klingensmith ME, Chen LE, Glasgow SC, Goers TA, Melby SJ (2008). The Washington manual of surgery. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. ISBN 978-0-7817-7447-5 .
- ^ Simons MP, Aufenacker T, Bay-Nielsen M, Bouillot JL, Campanelli G, Conze J, et al. (August 2009). “European Hernia Society guidelines on the treatment of inguinal hernia in adult patients” . Hernia. 13 (4): 343–403. doi : 10.1007/s10029-009-0529-7 . PMC 2719730 . PMID 19636493 .
- ^ Rosenberg J, Bisgaard T, Kehlet H, Wara P, Asmussen T, Juul P, Strand L, Andersen FH, Bay-Nielsen M (February 2011). “Danish Hernia Database recommendations for the management of inguinal and femoral hernia in adults”. Dan Med Bull. 58 (2): C4243. PMID 21299930 .
- ^ Purkayastha S, Chow A, Athanasiou T, Tekkis P, Darzi A (July 2008). “Inguinal hernia” . BMJ Clin Evid. 2008. PMC 2908002 . PMID 19445744 .
- ^ Aasvang E, Kehlet H (July 2005). “Chronic postoperative pain: the case of inguinal herniorrhaphy”. Br J Anaesth. 95 (1): 69–76. doi : 10.1093/bja/aei019 . PMID 15531621 .
- ^ Inguinal Hernia Archived 2007-09-27 at the Wayback Machine .
- ^ “Inguinal Hernia” . UCSF Pediatric Surgery.
- ^ a b Fitzgibbons RJ, Giobbie-Hurder A, Gibbs JO, et al. (January 2006). “Watchful waiting vs repair of inguinal hernia in minimally symptomatic men: a randomized clinical trial” . JAMA. 295 (3): 285–92. doi : 10.1001/jama.295.3.285 . PMID 16418463 .
- ^ Simons, MP; Aufenacker, TJ; Berrevoet, F; Bingener, J; Bisgaard, T; Bittner, R; Bonjer, HJ; Bury, K; Campanelli, G (2017). World guidelines for groin hernia management (PDF).
- ^ Brooks, David. “Overview of treatment for inguinal and femoral hernia in adults” . www.uptodate.com. Retrieved 2017-11-19.
- ^ Rosenberg, Jacob; Bisgaard, Thue; Kehlet, Henrik; Wara, Pål; Asmussen, Torsten; Juul, Poul; Strand, Lasse; Andersen, Finn Heidmann; Bay-Nielsen, Morten (February 2011). “Danish Hernia Database recommendations for the management of inguinal and femoral hernia in adults”. Danish Medical Bulletin. 58 (2): C4243. ISSN 1603-9629 . PMID 21299930 .
- ^ “Inguinal hernia” . Mayo Clinic . 2017-08-11.
External links[ edit ]
- Indirect Inguinal Hernia – University of Connecticut Health Center
- Media related to Inguinal hernia at Wikimedia Commons
- Inguinal hernias
- Webarchive template wayback links
- Infobox medical condition (new)
- All articles with unsourced statements
- Articles with unsourced statements from October 2009
- Commons category link from Wikidata
- This page was last edited on 16 November 2018, at 16:26 (UTC).
- Text is available under the Creative Commons Attribution-ShareAlike License ;
- About Wikipedia
- Contact Wikipedia
- Cookie statement
- Mobile view