Diagnosis Of Inguinal Hernia Research Articles

Laparoscopic hydrocelectomy with transabdominal preperitoneal hernioplasty or iliopubic tract repair for treatment of encysted spermatic cord hydrocele.

An encysted spermatic cord hydrocele (ESCH) causes an inguinal swelling resembling an inguinal hernia (IH). An ESCH should be considered as a differential diagnosis of IH. Although laparoscopic operations have been performed to treat ESCHs in pediatric patients, such operations have not been reported in adults. This study was performed to evaluate the outcomes of laparoscopic hydrocelectomy for treatment of ESCHs in adults. The medical charts of 49 patients who underwent laparoscopic transabdominal hydrocelectomy for ESCHs from January 2015 to December 2020 at a single institution were retrospectively reviewed. The patients were divided into those with and without an IH. Laparoscopic hydrocelectomy was performed, and the internal inguinal ring was closed with iliopubic tract repair (IPTR) or transabdominal preperitoneal (TAPP) hernioplasty depending on the presence of an IH. The patients' age, ESCH location, postoperative complications, recurrence, and operating time were examined. The patients' mean age was 46.7 (20-77) years. All patients underwent laparoscopic hydrocelectomy without open conversion. ESCHs were more common on the right side (35/49, 71.4%) than on the left (14/49, 28.6%). The presenting symptom in all patients was inguinal swelling. The ESCH was located inside the inguinal canal in 47 patients and protruded to the abdominal cavity from the inguinal canal in 2 patients. After laparoscopic hydrocelectomy, 32 patients without an IH underwent IPTR and 17 patients with an IH underwent TAPP hernioplasty. The mean operating time was shorter in the IPTR than TAPP hernioplasty group. The postoperative complications and hospital stay were not different between the two groups. There were no recurrences in either group. Laparoscopic hydrocelectomy with IPTR or TAPP hernioplasty is safe and feasible for treatment of ESCHs in adults.

Laparoscopic Hydrocelectomy of Encysted Hydrocele of the Canal of Nuck with High Ligation in Children or Iliopubic Tract Repair in Adults.

Background: Encysted hydrocele of the canal of Nuck (EHCN) is homologous to spermatic cord hydrocele in males. EHCN causes swelling in the inguinal region and should be considered in the differential diagnosis of inguinal hernias and masses in females. Complete excision and internal inguinal ring closure are the recommended treatments for symptomatic EHCN. In this study, we aimed at evaluating the safety and feasibility of laparoscopic hydrocelectomy, as well as age-appropriate procedures for EHCN. Materials and Methods: The medical records of 161 female adults and children, who underwent laparoscopic transabdominal hydrocelectomy from January 2014 to December 2020 at a single institution, were reviewed retrospectively and symptoms, location of EHCN, type of fluid in EHCN, postoperative complications, recurrence, and operating time were analyzed. Laparoscopic hydrocelectomy was performed and the internal inguinal ring was closed with high ligation in children and iliopubic tract repair (IPTR) in adults. Results: Fifty-two pediatric (age 2-11 years) and 109 adult (age 21-51 years) female patients were included. More adult patients had inguinal pain (34.9%, 38/109) compared with children (3.8% 2/52) (P < .001). More EHCNs were located in the inguinal canal than protruding into the abdominal cavity in both groups. Regarding the fluid characteristics, hemorrhagic and inflammatory hydroceles were more common in adults than in children (P < .001). There were no serious complications, neither recurrence nor chronic pain was observed in either group except for a surgical-site hematoma in 1 adult patient. Conclusion: Laparoscopic hydrocelectomy together with additional age-appropriate procedures, including high ligation in children and IPTR in adults, is a safe and feasible method for treating EHCN.

CLINICO-EPIDEMIOLOGIC PROFILE OF INGUINAL HERNIA IN RURAL MEDICAL COLLEGE IN NORTHERN INDIA

Background: Inguinal hernias are one most common problem dealt by general surgeons and have signicant morbidity and mortality. In the developed countries, almost all of the inguinal hernias are recognized early and present early in the course of disease to the surgeon. However, in developing countries, quite a considerable percentage of it is not repaired leading to a higher incidence of morbidity and mortality. Hence, we planned this study to understand the clinico-epidemiologic prole of inguinal hernia in rural medical college in northern India. Methodology: This is a descriptive epidemiological, prospective study carried out in rural medical college. All patients who presented to the surgical wards and outpatient with a clinical diagnosis of inguinal hernia were included in the study. Results:Among the 92 patients included in the study, most of them were men (88) with a mean age of around 44 years, married (85) and farmer (48) by occupation. All the patients of inguinal hernia presented with the complaints of lump above the inguinal crease and had predominantly rightsided hernia. 5 patients had family history of hernia. Indirect inguinal hernias were predominant. 3 patients had recurrence of earlier operated hernia, while 5 patients had hernia on the opposite side. Most of the patients presented late to the hospital due to the lack of awareness of the disease. Conclusion: Late presentation of disease is the hallmark of this disease in rural areas due to the lack of awareness. Increasing awareness of the disease among general population will lead to inguinal hernias being detected at earlier stage and will decrease the morbidity due to this disease

Verdicts of Inguinal Hernia Surgery: Report of Rare Case

Background and aim: To present our experience with unexpected findings during hernia surgery, either unusual hernia contents or pathologic individuals, like neoplastic masses, masked as a hernia. Patients and methods: We studied retrospectively 550 patients with inguinal hernia who were admitted to our surgery department over a 6-year period. In addition, our study included patients complaining of inguinal protrusion, even without a definitive diagnosis of inguinal hernia upon admission. Results: Five patients presented with unusual hernial contents. Three of them had a vermiform appendix in their sac. Acute appendicitis (Amyand’shernia) was found in only one case. One patient had epiploic appendagitis related with a groin hernia. Moreover, an adult woman was diagnosed with ovarian and tubal inguinal hernia. Finally, we report a case of a massive extra testicular intra scrotal lipoma, initially misdiagnosed as a scrotal hernia. Conclusion: A hernia surgeon may encounter unexpected intraoperative findings. It is important to be prepared to detect them and apply the appropriate treatment.

The sensitivity of ultrasound in the clinical diagnosis of inguinal hernias in adults: a comparative study.

Ultrasonography (US) is a non-invasive, non-ionizing radiation modality highly successful at diagnosing inguinal hernia. The aim of this study is to demonstrate the accuracy of ultrasound in evaluating defects of fascia in inguinal hernias and compare with surgical findings. A total of 33 patients with a sonographic diagnosis of an inguinal hernia are included to study. After US, all patients underwent a blinded surgery and the surgical findings are compared with the US results. The sensitivity of US was found to be 100% and 80% for indirect and direct types, respectively. The mean size of the defect was found to be 22mm (max: 70mm, min: 6mm) with US; and 27mm (max: 50mm, min: 4mm) at surgery. The size of defects at US and in surgery were correlated with each other (p = 0.001).

A “sacless hernia” with the orifice obscured by a preperitoneal lipoma: A case report

Introduction and importanceWith the widespread use of laparoscopic inguinal hernia repair, it is known that some clinically evident inguinal hernias lack a peritoneal sac and are referred to as “sacless hernias”.Presentation of caseA 61-year-old man presented with a left inguinal bulge. On physical examination, the diagnosis of bilateral inguinal hernias was made, and laparoscopic transabdominal repair was performed. Intraoperatively, the left peritoneal hernia orifice was not identified from the peritoneal cavity and there was only a lipoma. Pressing the lipoma with forceps from inside the peritoneum confirmed the presence of a hernia. The preperitoneal space was opened and the hernia orifice revealed.DiscussionThe terminology and definition of sacless hernias are poorly defined, even though this is not a rare condition. Consistent with Russell's dogma, there are arguments that any prolapse can only be called a hernia if there is an accompanying peritoneal sac. The proportion of patients with sacless hernias and pure cord lipomas are very similar and these conditions are often confused. Detailed and repeated physical examination may distinguish a sacless hernia from a pure lipoma. A watchful waiting strategy is useful and ensures safety.ConclusionOnce the diagnosis of inguinal hernia is made on physical examination, open the preperitoneal cavity if a peritoneal hernia orifice was not identified during laparoscopy.

Inguinal hernia detected using radiography.

There are various clinical presentations of inguinal hernia. Computed tomography is a well‐known tool to help diagnose inguinal hernia; however, radiographs are rarely reported to be useful in this aspect. We present a rare case wherein radiographs helped in the diagnosis of inguinal hernia.

Comparison of Incidence of Inguinal Hernia among Obese and Normal Individuals: A Retrospective Analysis

Objective: The objective of the present study was to verify whether obesity is associated with the occurrence of inguinal hernia.&#x0D; This is a cross-sectional study carried out in a tertiary hospital, including 84 patients, with clinical diagnosis of inguinal hernia, who underwent hernia mesh repair during a 6-month period (January 2021 to June 2021). Demographic, anthropometric and diagnostic data for inguinal hernia were taken from the patients' medical records.&#x0D; The Chi-square test was used to calculate the significance of association.&#x0D; Results: A total of 84 patients were included in this study. The age of patients varied between 39 - 75 years, averaging 54.8 years.&#x0D; The study showed an association between BMI and two factors, namely: Age (P = .023) and size of the defect (P = .005). However, hernia type (P = .797) and its content (P = 0.061) did not show such an association.&#x0D; Conclusion: In conclusion, these results may be a useful guide for future studies about the relationship between BMI and hernia and may provide foundation for better understanding of the pathophysiology of hernia is obese.

Evaluation of Laparoscopic Versus Open Repair for Inguinal Hernias

Background: The inguinal hernia is a protrusion of abdominal contents into the inguinal canal through an abdominal wall defect, and the risk of inguinal hernia increases with age. Currently, inguinal hernia repair with a mesh is the mostly common method through surgical procedure. Objective: To compare the outcome of laparoscopic versus open repair for inguinal hernias. Patients and Methods: This prospective comparative study conducted at General Surgery Department, Faculty of Medicine, Zagazig University at the period between January 2021 till July 2021, between open technique (preperitoneal approach, conventional Lichtenstein repair) versus laparoscopic transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) mesh repair of inguinal hernia. 24 patients were randomized into 2 groups by the closed envelop method, 12 patients underwent open repair operation and 12 patients underwent laparoscopic repair operation. The clinical diagnosis of inguinal hernia was based on symptoms and signs elicited during clinical assessment. Results: we found that mean duration of operation in laparoscopic group was longer than open group with significant difference, as regard length of hospital stay there was significant differences between two groups. Return to daily activity (Days) was early among laparoscopic inguinal hernia repair group with mean 1.67±0.49 and range from 1 to 2 days versus 4.58±1.5 with range from 3 to 7 days in open repair for inguinal hernia group, the difference was highly statistically significant. Conclusions: Laparoscopic surgical techniques for inguinal hernia repair (TAPP and TEP) can be carried out with a very low rate of predominantly harmless complications and with an acceptable duration of operation.

Factors associated with inguinal hernia repair in premature infants during neonatal admission

IntroductionTiming of inguinal hernia repair (IHR) in premature infants is variable and influenced by surgeon preference and complication profile. The purpose of this study was to evaluate factors related to early IHR, defined as hernia repair during initial neonatal admission, in premature infants. MethodsNeonatal hospitalizations of premature infants (gestational age at birth < 37 weeks and ≤ 28 days old at admission), with a diagnosis of inguinal hernia from 2010 to 2017 in HCUP National Inpatient Sample and Kid's Inpatient Sample databases were evaluated. Multivariable Cox proportional hazard models was used to estimate associations between demographics, additional procedures, hospital characteristics, and early IHR. ResultsOverall, 30,298 neonatal hospitalizations of premature infants with inguinal hernia were identified; 13,228 (43.3%) underwent early IHR. Early IHR was more likely with older gestational age at birth (35–36 weeks vs < 24 weeks, HR 6.05, 95% CI 4.17, 8.79), female sex (HR 1.20, 95% CI 1.07, 1.34), and undergoing concomitant gastrostomy (HR 2.51, 95% CI 1.72, 3.66). Non-Hispanic Black infants (HR 0.84, 95% CI 0.75, 0.95), infants at urban non-teaching hospitals (HR 0.15, 95% CI 0.07, 0.33), and infants at rural hospitals (HR 0.81, 95% CI 0.70, 0.97) were less likely to undergo early IHR. ConclusionsUsing a nationally representative database, early IHR in premature neonates was more commonly performed in non-Hispanic White, female neonates and at urban teaching hospitals. Patient race and hospital type were determinants of early IHR in premature neonates. There is a need to further evaluate the impact of race and socioeconomic factors on outcomes of common pediatric operations like inguinal hernia repairs. Level of EvidenceLevel III.

Study of Laparoscopic Inguinal Hernia Repair Using an Anatomically Contoured 3D Mesh

Background: Laparoscopic inguinal hernia surgery frequently is performed with mechanical fixation of polypropylene mesh. This mechanical fixation, though is necessary to prevent mesh migration, may be associated with pain syndromes and buckling. Recently an anatomically contoured 3D mesh (developed by Dr. Philippe Pajotin) has been introduced which is made up of monofilament polypropylene and resembles normal inguinal area curvature.&#x0D; Aims and Objective: This study was conducted to know whether elimination of tacking the 3D mesh during Total extraperitoneal approach (TEP) inguinal hernia repair results in decreased postoperative pain without increasing the incidence of hernia recurrence.&#x0D; Materials and Methods: This was a prospective interventional study in which 63 patients with clinical diagnosis of inguinal hernia were included on the basis of a predefined inclusion and exclusion criteria. All selected patients underwent laparoscopic TEP inguinal hernia repair using anatomically contoured 3D mesh. Patients were assessed for postoperative pain (using visual analogue scale) during their stay in the hospital as well as in the followup period.&#x0D; Results: In this study of Lap aroscopic inguinal hernia surgery using anatomically contoured 3D mesh of 63 male patients the most common affected age group was found to be 41-50 years (25.3%) with a mean age of 47.12 years +/- 13.01. Most common inguinal hernia was of indirect type (50.7%) and was seen on right side (52.3%). Mean operative time was 113.57+/- 29.04 minutes in unilateral and 170.6 ± 5.85 minutes in bilateralinguinal hernias. Postoperative mean VAS score (12 hrs) was found to be 3.46 ± 1.51. During follow up at 1 week, 1 month and 3 months mean VAS scores were found to be 0.46 ± 0.50, 0.14 ± 0.35 and 0.01 ± 0.12 respectively. Common complications included seroma (12.6%), pneumoscrotum (7.9%) and peritoneal breech (6.3%). None of the patients developed recurrence during follow up period.&#x0D; Conclusion: An anatomically contoured mesh for laparoscopic preperitoneal hernia repair usually requires no fixation and has minimal complications. It is associated with excellent recovery and marked reduction in pain.

Direct inguinal hernias in children

AIM: Based on the accumulated clinical material, this study aims to show the possibilities of diagnosing and treating direct inguinal hernias in children.&#x0D; MATERIALS AND METHODS: During the period from 2000 to 2020, 3221 children with inguinal hernias were treated in the surgical department of the Republican Childrens Clinical Hospital in Syktyvkar. Of the above group of children with inguinal hernias, seven patients (0.22%) had direct inguinal hernias. The above was confirmed by ultrasound examination. In laparoscopic imaging, a rectal hernia was defined as a recess of the peritoneum of a stellate or rounded shape in the projection of the medial umbilical fossa. Two patients underwent the Bassini herniation procedure. Two children underwent laparoscopic hernia repair with intracorporeal suture insertion. In three patients, hernia repair was performed using the PRMS method.&#x0D; RESULTS: Long-term results were followed up from six months to 15 years. Immediate and postoperative complications were noted. No recurrence of hernia was reported.&#x0D; CONCLUSIONS: When establishing direct inguinal hernia diagnosis in children is clinically determined in the form of a rounded, soft-elastic formation localized medially and above the Pupart ligament next to the projection of the external (superficial) inguinal ring of the inguinal canal. It is easily set into the abdominal cavity with rumbling and confirmed by ultrasound examination results. The most preferred treatment method for direct inguinal hernia in children, in our opinion, is hernia repair using the percutaneous internal ring suturing (PIRS) method.

Surgical and non-surgical treatment of inguinal hernia during non-elective admissions in the Nationwide Readmissions Database.

Inguinal hernia repair is one of the most common surgical operations, yet the optimal treatment strategy remains undefined. Treatment of symptomatic inguinal hernias include both surgical and non-surgical approaches. The objective of this study was to determine differences in population, readmission rates, and costs between operative and non-operative approaches for patients admitted non-electively for an inguinal hernia in a national dataset. In addition, we sought to define the baseline characteristics of the two groups and identify potential predictive factors in the non-surgically managed subgroup who were readmitted and treated operatively within 90days of their first visit. This study was a retrospective review of data from the Nationwide Readmissions Database (NRD) from 2010 to 2014. Patients above age 18 who were admitted non-electively for a primary diagnosis of inguinal hernia were included. Patients whose length of stay was < 1% or > 95% percentile or died during the initial visit were excluded. Readmissions within 90days of the initial visit were flagged. Patients were classified according to initial management strategy: operative versus non-operative. Demographic, clinical, and organizational characteristics were compared between the two cohorts. 14,249 patients met inclusion criteria and were operative (n = 8996, 63.13%) and non-operative (n = 5255, 36.88%) cohorts. When comparing the two groups, readmission rate was lower (0.49% for surgical, 1.78% for non-surgical, p < 0.01), mean length of stay (LOS) longer (3.27 [SE = 0.05] days for surgical, 2.76days [SE = 0.06] for non-surgical, p < 0.01), and mean total cost higher ($9597 for surgical, $7167 for non-surgical, p < 0.01) in surgically treated patients. The non-surgical population was on average older (63.05 years for surgical, 64.52 years for non-surgical, p < 0.01) with more chronic conditions (3.57 for surgical, 4.05 for non-surgical, p < 0.01). Of the patients initially managed non-surgically, 1.78% (n = 91) were readmitted, and of them, 62.63% (n = 57) were readmitted and managed surgically within 90days of initial admission (i.e., crossed over from watchful waiting to surgical treatment). Average number of chronic conditions (3.79 versus 4.03, p = 0.74), average number of comorbidities (2.26 versus 2.18, p = 0.87), and average total number of ICD-9 discharge codes (7.44 versus 8.23 p = 0.54 did not differ significantly between the operative versus non-operative sample of the readmitted population. The total cost ($5562.38 versus $8737.28, p = 0.01) was greater in the operative versus non-operative sample. Watchful-waiting strategy is the most common treatment approach in patients admitted non-electively for symptomatic inguinal hernia. Readmission after non-elective hospitalization for inguinal hernia is rare, but surgical intervention decreased the likelihood of readmission compared to non-operative management, while also increasing LOS and cost of care. Our data supports a patient centric approach to the management; non-surgical treatment is a viable temporary option even in symptomatic inguinal hernias, while surgical treatment may reduce the likelihood of future readmission.

Clinical presentation of inguinal hernia among adults in Uyo, Nigeria.

Inguinal hernia is a common pathology seen by the general surgeon in the outpatient clinic. Its spectrum of clinical features on presentation significantly varies from the asymptomatic to the complicated. To identify and audit the common clinical presentation and presence of known risk factors for inguinal hernia among adult patients with inguinal hernias presenting to an outpatient clinic. The study involved adults presenting over 1 year at a surgical clinic with a clinical diagnosis of inguinal hernia. Data on age, sex, family history, abdominal pain, constipation, chronic cough, previous hernia surgery as well as features of bladder outlet obstruction and intra-abdominal mass were recorded into a format. Analysis into a simple percentage, mean, and standard deviation was done with SPSS version 17 (SPSS Inc. Chicago, IL, USA). Sixty-five patients were enrolled in the study, comprising 49 males (75.4%) and 16 females (24.6%), M:F = 3:1. The mean age was 45.6 years (SD ± 16.9). The 16-40-year age group had the highest incidence of 29 cases (44.6%) of inguinal hernia. A family history of inguinal hernia (31 cases [47.7%]) and history of previous inguinal hernia surgery (15 cases [23.1%])) was observed. Ten patients with previous surgery presented with a contralateral hernia and 5 with a recurrence. Other factors were chronic constipation 10 cases, smoking 9 cases, chronic cough 8 cases, dysuria 7 cases, enlarged prostate 6 cases, abdominal mass 4 cases, and urethral stricture 1 case. Inguinal hernia is common among young and middle-aged adults in our series. Many patients have features suggestive of complications at presentation. Family history and past inguinal hernia surgery were important risk factors.

MASTECTOMI PADA KUCING MASTITIS

This case was recorded at the Faculty of Veterinary Medicine, University of Wijaya Kusuma Surabaya. Oreo cats were found with a state of weakness, severe dehydration, and a lump in the lower abdomen. The results of the physical examination of Oreo cats were diagnosed as having a mammary carcinoma, with a differential diagnosis of inguinal hernia, and mastitis. To confirm the diagnosis, blood tests and X-ray supporting examinations are carried out. From the results of the examination, the results of the blood check showed normal results, but on the X-Ray examination, there was an intermediate opacity on the part of the bulge and no ring was found that led to the hernia diagnosis. The consistency of the bulge at the time of the xray was slightly changed when compared to when the cat was found, where the consistency of the bulge became slightly flaccid accompanied by a yellowish-white discharge from the oreo cat's nipples. Based on the x-ray results that show the presence of intermediate colored opacity and the discharge of cloudy yellow milk, it can be concluded that the Oreo cat has chronic mastitis. Surgery and removal of the mammary glands (mastectomy) are still the best treatment options. In a mastectomy, the incision is performed in an ellipse, prepared from the surrounding tissue, then the nipple is removed.).

Characterization of Patients with Inguinal Hernia Ambulatory Surgical Treatment

Introduction: the surgical treatment of inguinal hernia has increased in the last decade and its prevalence is not known. Objective: Characterization of patients with inguinal hernia ambulatory surgical treatment. Methods: an observational, descriptive and prospective study of 972 patients with the diagnosis of inguinal hernia was performed, which were operated on an outpatient basis in the General Teaching Hospital "Enrique Cabrera" since January. From 2009 to December 2020. Emergency operated patients were excluded. Results: the highest incidence of inguinal hernia was found between the ages of 60 and 80 years. Indirect right inguinal hernia appeared more frequently. Desarda's anatomic surgical technique was the most applied in 410 (42,1%) of the cases and Lichtenstein's hernioplasty with 224 (23.0%) followed in frequency. There was a total of 5 (0.5%) recurrences. Local anesthesia was applied in 828 (85.2%) of the patients, on an outpatient basis they were 100%. The total complications were 42 (4.3%). Conclusions: surgical treatment of inguinal hernia on an outpatient basis is an appropriate process. It creates comfort in patients, decreases the risk of hospital infection, and reduces waiting lists and hospital costs.

Characterization of Patients with Inguinal Hernia Ambulatory Surgical Treatment

An observational, descriptive and prospective study of 972 patients with the diagnosis of inguinal hernia was performed, which were operated on an outpatient basis in the General Teaching Hospital 'Enrique Cabrera' since January 2009 to December 2020. Emergency operated patients were excluded.

Infant malignant ectomesenchymoma masquerading as inguinal hernia in two patients

Infant malignant ectomesenchymoma masquerading as inguinal hernia in two patients

Urinary bladder herniation in the differential diagnosis of inguinal hernia

Urinary bladder hernia is a clinical condition that mimics symptoms of inguinal hernia. It is vital to predict and prevent the iatrogenic bladder injury that may develop secondary to inguinal bladder herniation during inguinal hernia surgery, which is frequently performed, and to be able to determine our preoperative and perioperative surgical approaches. Patients with a diagnosis of inguinal hernia who underwent elective and emergency surgery between 2018 and 2020 were reviewed retrospectively. Age, gender, body mass indexes, imaging modalities, operation techniques, duration of hospital stay, perioperative and postoperative morbidity and mortality of the patients were recorded. Bladder herniation was found in seven patients, five of whom underwent elective surgery and two of whom underwent emergency surgery. The median age of the patients was 84 (min.52-max 89). Perioperative bladder injury was observed in two of the 6 patients who underwent computed tomography in the past year. Two patients, who had a bladder injury, underwent primary repair and were followed up with a foley catheter. Postoperative duration of hospitalization was 3.28 (2-7) days on average and the duration of hospitalization was prolonged up to an average of 6 (5-7) days in two patients with bladder injury. No postoperative mortality and morbidity were observed. It should be taken into consideration that there may be urinary bladder herniation in the differential diagnosis of inguinal swelling in patients presenting with symptoms of inguinal hernia at an advanced age. There is a need for methods that may reduce the morbidity and mortality secondary to bladder herniation.

Contents of the inguinal canal: identification by different imaging methods.

Although the correct diagnosis of inguinal hernias can often be made by clinical examination, there are several situations in which imaging methods represent the best option for evaluating such hernias, their content, and the possible complications. In addition, bulging of the inguinal region is not always indicative of a hernia, because other lesions, including tumors, cysts, and hematomas, also affect the region. The objective of this pictorial essay is to demonstrate what can be identified within inguinal hernias. Differentiating the types of herniated structures is of absolute importance for planning the appropriate treatment.