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• fever
What are the symptoms of
• rapid heart rate
inguinal hernia?
Symptoms of inguinal hernia include Left untreated, nausea, vomiting, and severe
infection can occur. If surgery is not per
• a small bulge in one or both sides of formed right away, the condition can become
the groin that may increase in size and life threatening, and the affected intestine
disappear when lying down; in males, may die. Then that portion of the intestine
it can present as a swollen or enlarged must be removed.
scrotum
• discomfort or sharp pain—especially How is inguinal hernia
when straining, lifting, or exercising— diagnosed?
that improves when resting
To diagnose inguinal hernia, the doctor takes
• a feeling of weakness or pressure in the a thorough medical history and conducts a
groin physical examination. The person may be
• a burning, gurgling, or aching feeling at asked to stand and cough so the doctor can
the bulge feel the hernia as it moves into the groin or
scrotum. The doctor checks to see if the
hernia can be gently massaged back into its
proper position in the abdomen.
2 Inguinal Hernia
How is inguinal hernia best option if the hernia is very large or the
person has had pelvic surgery.
treated?
In adults, inguinal hernias that enlarge, Most adults experience discomfort after sur
cause symptoms, or become incarcerated are gery and require pain medication. Vigorous
treated surgically. In infants and children, activity and heavy lifting are restricted for
inguinal hernias are always operated on to several weeks. The doctor will discuss when
prevent incarceration from occurring. Sur a person may safely return to work. Infants
gery is usually done on an outpatient basis. and children also experience some discom
Recovery time varies depending on the size fort but usually resume normal activities
of the hernia, the technique used, and the after several days.
age and health of the patient. The two main
types of surgery for hernias are as follows: What are the complications
• “Open” hernia repair. In open hernia of surgery for inguinal
repair, also called herniorrhaphy, a hernia?
person is given local anesthesia in the
Surgery to repair an inguinal hernia is quite
abdomen or spine to numb the area,
safe and complications are uncommon.
general anesthesia to sedate or help the
Knowing possible risks allows patients to
person sleep, or a combination of the
report postoperative symptoms to their doc
two. Then the surgeon makes an inci
tor as soon as they occur.
sion in the groin, moves the hernia back
into the abdomen, and reinforces the • Risk of general anesthesia. Before
muscle wall with stitches. Usually the surgery, the anesthesiologist—a doctor
area of muscle weakness is reinforced who administers anesthesia—reviews
with a synthetic mesh or screen to pro the risks of anesthesia with the patient
vide additional support—an operation and asks about medical history and
called hernioplasty. allergies to medications. Complications
• Laparoscopy. Laparoscopic surgery is most likely occur in older people and
performed using general anesthesia. those with other medical conditions.
The surgeon makes several small inci Common complications include nausea,
sions in the lower abdomen and inserts vomiting, urinary retention, sore throat,
a laparoscope—a thin tube with a tiny and headache. More serious problems
video camera attached to one end. The include heart attack, stroke, pneumonia,
camera sends a magnified image from and blood clots in the legs.
inside the body to a monitor, giving the Getting out of bed after surgery and
surgeon a close-up view of the hernia moving as soon as the doctor allows will
and surrounding tissue. While viewing help reduce the risk of complications
the monitor, the surgeon uses instru such as pneumonia and blood clots.
ments to carefully repair the hernia
using synthetic mesh. • Hernia recurrence. A hernia can recur
up to several years after repair. Recur
People who undergo laparoscopic surgery rence is the most common complica
generally experience a somewhat shorter tion of inguinal hernia repair, causing
recovery time. However, the doctor may patients to undergo a second operation.
determine laparoscopic surgery is not the Hernia recurrence occurs less often
when a hernioplasty is performed.
3 Inguinal Hernia
• Bleeding. Bleeding inside the incision is Points to Remember
another complication of inguinal hernia
• An inguinal hernia is a condition in
repair. It can cause severe swelling and
which intra-abdominal fat or part of
bluish discoloration of the skin around
the small intestine, also called the small
the incision. Surgery may be necessary
bowel, bulges through a weak area in
to open the incision and stop the bleed
the lower abdominal muscles. An ingui
ing. Bleeding is unusual and occurs in
nal hernia occurs in the groin—the area
less than 2 percent of patients.1
between the abdomen and thigh.
• Wound infection. The risk of wound
• An inguinal hernia can occur any time
infection is small—less than 2 percent—
from infancy to adulthood and is much
and is more likely to occur in older
more common in males than females.
adults and people who undergo more
complex hernia repair.2 The person • Direct and indirect hernias are the two
may experience a fever, discharge types of inguinal hernia, and they have
from the incision, and redness, swelling, different causes.
or tenderness around the incision. Post • Symptoms of an inguinal hernia usually
operative infection requires antibiotics appear gradually and include a bulge in
and, occasionally, another procedure the groin, discomfort or sharp pain, a
requiring local anesthesia to make a feeling of weakness or pressure in the
small opening in the incision and drain groin, and a burning, gurgling, or aching
the infection. feeling at the bulge.
• Painful scar. Sometimes people expe • An incarcerated inguinal hernia is a her
rience sharp, tingling pain in a spe nia that becomes stuck in the groin or
cific area near the incision after it has scrotum and cannot be massaged back
healed. The pain usually resolves with into the abdomen.
time. Medicine may be injected in the
area if the pain continues. • A strangulated hernia, in which the
blood supply to the incarcerated small
• Injury to internal organs. Although intestine is jeopardized, is a serious con
extremely rare, injury to the intestine, dition and requires immediate medical
bladder, kidneys, nerves and blood ves attention. Symptoms include extreme
sels leading to the legs, internal female tenderness and redness in the area of
organs, and vas deferens—the tube the bulge, sudden pain that worsens
that carries sperm—can occur during quickly, fever, rapid heart rate, nausea,
hernia surgery and may lead to more and vomiting.
operations.
• An inguinal hernia is diagnosed through
a physical examination.
• Inguinal hernias may be repaired
through surgery. Surgery is performed
through one incision or with a laparo
scope and several small incisions.
1Freeman ME, Smith SL. Inguinal hernia: open
repair. In: Hinder RA, Kelly KA, Sarr MG, eds. Mayo
Clinic Gastrointestinal Surgery. St. Louis: Elsevier
Science; 2004: 679–689.
2Ibid.
4 Inguinal Hernia
• Surgery for inguinal hernia is usually For More Information
done on an outpatient basis. Recovery
American Academy of Family Physicians
time varies depending on the size of the
P.O. Box 11210
hernia, the technique used, and the age
Shawnee Mission, KS 66207–1210
and health of the patient.
Phone: 1–800–274–2237 or 913–906–6000
• Complications from inguinal hernia Email: fp@aafp.org
surgery are rare and can include general Internet: www.aafp.org
anesthesia complications, hernia recur-
rence, bleeding, wound infection, pain- American College of Surgeons
ful scar, and injury to internal organs. 633 North Saint Clair Street
Chicago, IL 60611–3211
Phone: 1–800–621–4111 or 312–202–5000
Hope through Research Fax: 312–202–5001
The National Institute of Diabetes and Email: postmaster@facs.org
Digestive and Kidney Diseases’ Division of Internet: www.facs.org
Digestive Diseases and Nutrition supports
basic and clinical research into digestive and American Pediatric Surgical Association
abdominal conditions. Scientists and sur- 60 Revere Drive, Suite 500
geons continue to evaluate ways to prevent Northbrook, IL 60062
postoperative complications following ingui- Phone: 847–480–9576
nal hernia repair. New technologies and Fax: 847–480–9282
materials are being developed to improve Email: eapsa@eapsa.org
existing surgical techniques for all types of Internet: www.eapsa.org
inguinal hernia repair and to decrease hernia
recurrence rates. Acknowledgments
Participants in clinical trials can play a more Publications produced by the Clearinghouse
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access to new research treatments before scientists and outside experts. This publica-
they are widely available, and help others tion was reviewed by Michael G. Sarr, M.D.,
by contributing to medical research. For Mayo Clinic.
information about current studies, visit
www.ClinicalTrials.gov.
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