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Inguinal Hernia
Bryan R. Foster, MD
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KEY FACTS

  • Terminology

    • Imaging

      TERMINOLOGY

      • Definitions

        • Protrusion of organ (or tissue) outside its physiologic cavity
        • Indirect hernia: Hernia protruding through internal inguinal ring
        • Direct hernia: Hernia protruding through Hesselbach triangle
        • Incarcerated hernia: Entrapment of hernia content within hernia sac (irreducible)
        • Strangulated hernia: Compromised blood flow to hernia content resulting in ischemia/necrosis of contents
        • Amyand hernia: Inguinal hernia containing appendix
        • Pantaloon hernia: Combined indirect and direct hernias

      IMAGING

      • Relevant Anatomy

        • Relevant Embryology

          • Radiographic Findings

            • CT Findings

              • Ultrasonographic Findings

                • Imaging Recommendations

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      CLINICAL ISSUES

                      • Presentation

                        • Demographics

                          • Natural History & Prognosis

                            • Treatment

                              DIAGNOSTIC CHECKLIST

                              • Consider

                                • Image Interpretation Pearls

                                  Selected References

                                  1. Gavlin A et al: Imaging and treatment of complications of abdominal and pelvic mesh repair. Radiographics. 40(2):432-53, 2020
                                  2. Miller HJ: Inguinal Hernia: Mastering the Anatomy. Surg Clin North Am. 98(3):607-21, 2018
                                  3. Schoettle A et al: The lateral crescent sign. Abdom Radiol (NY). 43(11):3195-6, 2018
                                  4. Cabarrus MC et al: From inguinal hernias to spermatic cord lipomas: pearls, pitfalls, and mimics of abdominal and pelvic hernias. Radiographics. 37(7):2063-82, 2017
                                  5. Revzin MV et al: US of the inguinal canal: comprehensive review of pathologic processes with CT and MR imaging correlation. Radiographics. 36(7):2028-48, 2016
                                  6. Jacobson JA et al: Ultrasound of the Groin: Techniques, Pathology, and Pitfalls. AJR Am J Roentgenol. 205(3):513-23, 2015
                                  7. Murphy KP et al: Adult abdominal hernias. AJR Am J Roentgenol. 202(6):W506-11, 2014
                                  8. Burkhardt JH et al: Diagnosis of inguinal region hernias with axial CT: the lateral crescent sign and other key findings. Radiographics. 31(2):E1-12, 2011
                                  9. Stamatiou D et al: Obturator hernia revisited: surgical anatomy, embryology, diagnosis, and technique of repair. Am Surg. 77(9):1147-57, 2011
                                  10. Aguirre DA et al: Abdominal wall hernias: imaging features, complications, and diagnostic pitfalls at multi-detector row CT. Radiographics. 25(6):1501-20, 2005
                                  11. Jaffe TA et al: MDCT of abdominal wall hernias: is there a role for valsalva's maneuver? AJR Am J Roentgenol. 184(3):847-51, 2005
                                  12. Zollinger RM Jr: An updated traditional classification of inguinal hernias. Hernia. 8(4):318-22, 2004
                                  13. van den Berg JC: Inguinal hernias: MRI and ultrasound. Semin Ultrasound CT MR. 23(2):156-73, 2002
                                  14. Toms AP et al: Illustrated review of new imaging techniques in the diagnosis of abdominal wall hernias. Br J Surg. 86(10): 1243-9, 1999
                                  Related Anatomy
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                                  Related Differential Diagnoses
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                                  References
                                  Tables

                                  Tables

                                  KEY FACTS

                                  • Terminology

                                    • Imaging

                                      TERMINOLOGY

                                      • Definitions

                                        • Protrusion of organ (or tissue) outside its physiologic cavity
                                        • Indirect hernia: Hernia protruding through internal inguinal ring
                                        • Direct hernia: Hernia protruding through Hesselbach triangle
                                        • Incarcerated hernia: Entrapment of hernia content within hernia sac (irreducible)
                                        • Strangulated hernia: Compromised blood flow to hernia content resulting in ischemia/necrosis of contents
                                        • Amyand hernia: Inguinal hernia containing appendix
                                        • Pantaloon hernia: Combined indirect and direct hernias

                                      IMAGING

                                      • Relevant Anatomy

                                        • Relevant Embryology

                                          • Radiographic Findings

                                            • CT Findings

                                              • Ultrasonographic Findings

                                                • Imaging Recommendations

                                                  DIFFERENTIAL DIAGNOSIS

                                                    PATHOLOGY

                                                    • General Features

                                                      CLINICAL ISSUES

                                                      • Presentation

                                                        • Demographics

                                                          • Natural History & Prognosis

                                                            • Treatment

                                                              DIAGNOSTIC CHECKLIST

                                                              • Consider

                                                                • Image Interpretation Pearls

                                                                  Selected References

                                                                  1. Gavlin A et al: Imaging and treatment of complications of abdominal and pelvic mesh repair. Radiographics. 40(2):432-53, 2020
                                                                  2. Miller HJ: Inguinal Hernia: Mastering the Anatomy. Surg Clin North Am. 98(3):607-21, 2018
                                                                  3. Schoettle A et al: The lateral crescent sign. Abdom Radiol (NY). 43(11):3195-6, 2018
                                                                  4. Cabarrus MC et al: From inguinal hernias to spermatic cord lipomas: pearls, pitfalls, and mimics of abdominal and pelvic hernias. Radiographics. 37(7):2063-82, 2017
                                                                  5. Revzin MV et al: US of the inguinal canal: comprehensive review of pathologic processes with CT and MR imaging correlation. Radiographics. 36(7):2028-48, 2016
                                                                  6. Jacobson JA et al: Ultrasound of the Groin: Techniques, Pathology, and Pitfalls. AJR Am J Roentgenol. 205(3):513-23, 2015
                                                                  7. Murphy KP et al: Adult abdominal hernias. AJR Am J Roentgenol. 202(6):W506-11, 2014
                                                                  8. Burkhardt JH et al: Diagnosis of inguinal region hernias with axial CT: the lateral crescent sign and other key findings. Radiographics. 31(2):E1-12, 2011
                                                                  9. Stamatiou D et al: Obturator hernia revisited: surgical anatomy, embryology, diagnosis, and technique of repair. Am Surg. 77(9):1147-57, 2011
                                                                  10. Aguirre DA et al: Abdominal wall hernias: imaging features, complications, and diagnostic pitfalls at multi-detector row CT. Radiographics. 25(6):1501-20, 2005
                                                                  11. Jaffe TA et al: MDCT of abdominal wall hernias: is there a role for valsalva's maneuver? AJR Am J Roentgenol. 184(3):847-51, 2005
                                                                  12. Zollinger RM Jr: An updated traditional classification of inguinal hernias. Hernia. 8(4):318-22, 2004
                                                                  13. van den Berg JC: Inguinal hernias: MRI and ultrasound. Semin Ultrasound CT MR. 23(2):156-73, 2002
                                                                  14. Toms AP et al: Illustrated review of new imaging techniques in the diagnosis of abdominal wall hernias. Br J Surg. 86(10): 1243-9, 1999