Brian P. Jacob, David C. Chen, Bruce Ramshaw, Shirin Towfigh (eds.) - The SAGES Manual of Groin Pain-Springer International Publishing (2016)

6. Groin Pain Etiology: The Inguinal
Hernia, the Occult Inguinal Hernia,
and the Lipoma
Ibrahim M. Daoud and Katherine Dunn
Inguinal Hernia
Epidemiology/Etiology The inguinal hernia is one of the most common
reasons that a general practitioner would refer a patient to a general
surgeon. Inguinal hernias can present with a wide array of symptoms,
including groin pain, burning, aching, or worsening pressure in the groin
throughout the day. Those with hernias may also complain of a lump or
a bulge on the affected side. On the other hand, many patients do not
complain of a bulge, but instead present with a chief complaint of groin
pain—unaware of the vast differential diagnosis list involved. Though
the differential diagnosis for groin pain is quite long and can include
such diagnoses as chronic appendicitis, diverticulitis, urologic diseases,
and gynecological processes, an inguinal hernia is a common cause not
to be overlooked [ 1 ]. This chapter focuses on inguinal hernias, as well
as on the occult inguinal hernia, and the lipoma of the spermatic cord or
round ligament.
Abdominal wall hernias account for 4.7 million ambulatory care
visits each year, more than 600,000 of which are inguinal hernias that
undergo repair [ 2 ]. Inguinal hernias present with a 9:1 male predominance,
are more common on the right, and are most commonly in the
40–59 year age group. Indirect hernias are twice as likely to be present
when compared with direct hernias [ 3 ]. In women, as in men, indirect
hernias are the most common inguinal hernia. Femoral hernias, however,
are relatively more common in women when compared to men,
comprising 20 % of all groin hernias in women [ 1 ].
© Springer International Publishing Switzerland 2016
B.P. Jacob et al. (eds.), The SAGES Manual of Groin Pain,
DOI 10.1007/978-3-319-21587-7_6
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