Global InformationInguinal hernia information
| Inguinal hernia | |
|---|---|
 | |
| Diagram of an indirect, scrotal inguinal hernia (median view from the left). | |
| Pronunciation |
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| Specialty | General surgery |
| Symptoms | Pain, bulging in the groin[1] |
| Complications | Strangulation[1] |
| Usual onset | < 1 year old, > 50 years old[2] |
| Risk factors | Family history, smoking, chronic obstructive pulmonary disease, obesity, pregnancy, peritoneal dialysis, collagen vascular disease, connective tissue disease, previous open appendectomy[1][2][3] |
| Diagnostic method | Based on symptoms, medical imaging[1] |
| Treatment | Conservative, surgery[1] |
| Frequency | 27% (males), 3% (females)[1] |
| Deaths | 59,800 (2015)[4] |
An inguinal hernia or groin hernia is a hernia (protrusion) of abdominal cavity contents through the inguinal canal. Symptoms, which may include pain or discomfort especially with or following coughing, exercise, or bowel movements, are absent in about a third of patients. Symptoms often get worse throughout the day and improve 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.[1]
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.[1][2] Predisposition to hernias is genetic[5] and they occur more often in certain families.[6][7][8][1] Deleterious mutations causing predisposition to hernias seem to have dominant inheritance (especially for men). 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.[1]
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 (also a type of groin hernia) 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.[1][9]
In 2015 inguinal, femoral and abdominal hernias affected about 18.5 million people.[10] About 27% of males and 3% of females develop a groin hernia at some time in their life.[1] Groin hernias occur most often before the age of one and after the age of fifty.[2] Globally, inguinal, femoral and abdominal hernias resulted in 60,000 deaths in 2015 and 55,000 in 1990.[4][11]
- ^ a b c d e f g h i j k l Fitzgibbons RJ J, Forse RA (19 February 2015). "Clinical practice. Groin hernias in adults" (PDF). The New England Journal of Medicine. 372 (8): 756–63. doi:10.1056/NEJMcp1404068. PMID 25693015. Archived from the original (PDF) on 18 November 2021. Retrieved 18 November 2021.
- ^ a b c d Domino FJ (2014). The 5-minute clinical consult 2014 (22nd ed.). Philadelphia, Pa.: Wolters Kluwer Health/Lippincott Williams & Wilkins. p. 562. ISBN 978-1-4511-8850-9.
- ^ 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. S2CID 27799467.
- ^ 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.
- ^ Öberg S, Andresen K, Rosenberg J (2017). "Etiology of Inguinal Hernias: A Comprehensive Review". Frontiers in Surgery. 4: 52. doi:10.3389/fsurg.2017.00052. PMC 5614933. PMID 29018803.
- ^ Mihailov E, Nikopensius T, Reigo A, Nikkolo C, Kals M, Aruaas K, et al. (2017). "Whole-exome Sequencing Identifies a Potential TTN Mutation in a Multiplex Family With Inguinal Hernia - PubMed". Hernia: The Journal of Hernias and Abdominal Wall Surgery. 21 (1): 95–100. doi:10.1007/s10029-016-1491-9. PMC 5281683. PMID 27115767.
- ^ Sezer S, Şimşek N, Celik HT, Erden G, Ozturk G, Düzgün AP, et al. (2014). "Association of Collagen Type I Alpha 1 Gene Polymorphism With Inguinal Hernia - PubMed". Hernia: The Journal of Hernias and Abdominal Wall Surgery. 18 (4): 507–12. doi:10.1007/s10029-013-1147-y. PMID 23925543. S2CID 22999363.
- ^ Gong Y, Shao C, Sun Q, Chen B, Jiang Y, Guo C, et al. (1994). "Genetic Study of Indirect Inguinal Hernia - PubMed". Journal of Medical Genetics. 31 (3): 187–92. doi:10.1136/jmg.31.3.187. PMC 1049739. PMID 8014965.
- ^ 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.