False hernia diagnosis?


Pain alone does not diagnose a hernia. This ct scan is of a patient who was convinced he had a hernia because he had right groin pain for 5 days. When I examined him there was no bulge. He did have right groin tenderness and right lower quadrant tenderness. I ordered a ct scan as an emergency which showed an appendix about to burst. He went straight to surgery and had his appendix removed.

Usually a hernia diagnosis is based on objective findings, which are rarely misinterpreted. An irreducible bulge may be an incarcerated hernia or a tumor. Either way it is serious and needs to be operated on. Sports hernias are diagnosed based on symptoms, that is, subjective evidence and can be made in error. But with a thorough careful clinical evaluation and radiological imagining when appropriate the error rate for diagnosing a sports hernia should be less than 5%.

A related but different question is do you repair a small asymptomatic hernia found incidentally during laparoscopy. My practice has been to leave these hernias alone. Laparoscopic hernia surgeons are currently evaluating this question.


Sports hernia
Amyand's hernia: a review.

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