Inguinal hernia differential diagnosis: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Inguinal_hernia]] | |||
{{CMG}}; {{AE}} {{F.K}} | {{CMG}}; {{AE}} {{F.K}} | ||
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==Differentiating inguinal hernia from other Diseases== | ==Differentiating inguinal hernia from other Diseases== | ||
*Inguinal hernia must be differentiated testicular torsion, [[epididymitis]], [[hydrocele]], [[varicocele]], [[spermatocele]], [[epididymal cyst]] and [[testicular tumor]].<ref name="pmid18244999">{{cite journal |vauthors=Jenkins JT, O'Dwyer PJ |title=Inguinal hernias |journal=BMJ |volume=336 |issue=7638 |pages=269–72 |year=2008 |pmid=18244999 |pmc=2223000 |doi=10.1136/bmj.39450.428275.AD |url=}}</ref><ref name="pmid14724878">{{cite journal |vauthors=Perrott CA |title=Inguinal hernias: room for a better understanding |journal=Am J Emerg Med |volume=22 |issue=1 |pages=48–50 |year=2004 |pmid=14724878 |doi= |url=}}</ref><ref name="pmid18029925">{{cite journal |vauthors=Oh SN, Jung SE, Rha SE, Lim GY, Ku YM, Byun JY, Lee JM |title=Sonography of various cystic masses of the female groin |journal=J Ultrasound Med |volume=26 |issue=12 |pages=1735–42 |year=2007 |pmid=18029925 |doi= |url=}}</ref><ref name="pmid17460003">{{cite journal |vauthors=Yang DM, Kim HC, Lim JW, Jin W, Ryu CW, Kim GY, Cho H |title=Sonographic findings of groin masses |journal=J Ultrasound Med |volume=26 |issue=5 |pages=605–14 |year=2007 |pmid=17460003 |doi= |url=}}</ref> | *Inguinal hernia must be differentiated testicular torsion, [[epididymitis]], [[hydrocele]], [[varicocele]], [[spermatocele]], [[epididymal cyst]] and [[testicular tumor]].<ref name="pmid18244999">{{cite journal |vauthors=Jenkins JT, O'Dwyer PJ |title=Inguinal hernias |journal=BMJ |volume=336 |issue=7638 |pages=269–72 |year=2008 |pmid=18244999 |pmc=2223000 |doi=10.1136/bmj.39450.428275.AD |url=}}</ref><ref name="pmid14724878">{{cite journal |vauthors=Perrott CA |title=Inguinal hernias: room for a better understanding |journal=Am J Emerg Med |volume=22 |issue=1 |pages=48–50 |year=2004 |pmid=14724878 |doi= |url=}}</ref><ref name="pmid18029925">{{cite journal |vauthors=Oh SN, Jung SE, Rha SE, Lim GY, Ku YM, Byun JY, Lee JM |title=Sonography of various cystic masses of the female groin |journal=J Ultrasound Med |volume=26 |issue=12 |pages=1735–42 |year=2007 |pmid=18029925 |doi= |url=}}</ref><ref name="pmid17460003">{{cite journal |vauthors=Yang DM, Kim HC, Lim JW, Jin W, Ryu CW, Kim GY, Cho H |title=Sonographic findings of groin masses |journal=J Ultrasound Med |volume=26 |issue=5 |pages=605–14 |year=2007 |pmid=17460003 |doi= |url=}}</ref> | ||
{| | {| | ||
|- style="background: #4479BA; color: #FFFFFF; text-align: center;" | |- style="background: #4479BA; color: #FFFFFF; text-align: center;" | ||
! rowspan="2" |Diseases | ! rowspan="2" |Diseases | ||
! colspan="4" |Clinical features | ! colspan="4" |Clinical features | ||
! rowspan="2" | | ! rowspan="2" |Imaging | ||
|- style="background: #4479BA; color: #FFFFFF; text-align: center;" | |- style="background: #4479BA; color: #FFFFFF; text-align: center;" | ||
!Swelling | !Swelling | ||
| Line 19: | Line 20: | ||
!Inguinal or scrotal | !Inguinal or scrotal | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Testicular torsion | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Testicular torsion]] | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | + | | style="background: #F5F5F5; padding: 5px; text-align: center;" | + | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | + | | style="background: #F5F5F5; padding: 5px; text-align: center;" | + | ||
| Line 28: | Line 29: | ||
enlargement, decreased echogenicity, and absent flow | enlargement, decreased echogenicity, and absent flow | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Epididymitis | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Epididymitis]] | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/- | | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/- | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | + | | style="background: #F5F5F5; padding: 5px; text-align: center;" | + | ||
| Line 35: | Line 36: | ||
| style="background: #F5F5F5; padding: 5px; " |'''Doppler ultrasonography:''' | | style="background: #F5F5F5; padding: 5px; " |'''Doppler ultrasonography:''' | ||
enlarged (>17 mm) epididymis with a hypoechoic, hyperechoic, or heterogeneous echotexture, increased blood flow | enlarged (>17 mm) [[epididymis]] with a hypoechoic, hyperechoic, or [[heterogeneous]] echotexture, increased blood flow | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Hydrocele | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Hydrocele]] | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | + | | style="background: #F5F5F5; padding: 5px; text-align: center;" | + | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | - | | style="background: #F5F5F5; padding: 5px; text-align: center;" | - | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | - | | style="background: #F5F5F5; padding: 5px; text-align: center;" | - | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Inguinal | | style="background: #F5F5F5; padding: 5px; text-align: center;" |[[Inguinal]] | ||
| style="background: #F5F5F5; padding: 5px; " |'''Ultrasound:''' | | style="background: #F5F5F5; padding: 5px; " |'''Ultrasound:''' | ||
simple fluid collection | simple fluid collection | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Varicocele | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Varicocele]] | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/- | | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/- | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/- | | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/- | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/- | | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/- | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Inguinal | | style="background: #F5F5F5; padding: 5px; text-align: center;" |[[Inguinal]] | ||
| style="background: #F5F5F5; padding: 5px; " |'''Ultrasonography:''' | | style="background: #F5F5F5; padding: 5px; " |'''Ultrasonography:''' | ||
tortuous, tubular, anechoic structures adjacent to the testis corresponding to dilated veins of the pampiniform plexus with calibers of 2–3 mm during the Valsalva maneuver | [[tortuous]], [[tubular]], anechoic structures adjacent to the testis corresponding to dilated veins of the [[pampiniform plexus]] with calibers of 2–3 mm during the [[Valsalva maneuver]] | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Spermatocele | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Spermatocele]] | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | + | | style="background: #F5F5F5; padding: 5px; text-align: center;" | + | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | - | | style="background: #F5F5F5; padding: 5px; text-align: center;" | - | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | | | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/- | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Inguinal | | style="background: #F5F5F5; padding: 5px; text-align: center;" |[[Inguinal]] | ||
| style="background: #F5F5F5; padding: 5px; " |'''Ultrasonography:''' | | style="background: #F5F5F5; padding: 5px; " |'''Ultrasonography:''' | ||
hypoechoic with posterior acoustic enhancement | hypoechoic with posterior acoustic enhancement | ||
| Line 66: | Line 67: | ||
falling snow, resulting from internal echoes moving away from the transducer | falling snow, resulting from internal echoes moving away from the transducer | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Testicular tumor | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Testicular tumor]] | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/- | | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/- | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/- | | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/- | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | + | | style="background: #F5F5F5; padding: 5px; text-align: center;" | + | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Inguinal | | style="background: #F5F5F5; padding: 5px; text-align: center;" |[[Inguinal]] | ||
| style="background: #F5F5F5; padding: 5px; " |'''Ultrasonography:''' | | style="background: #F5F5F5; padding: 5px; " |'''Ultrasonography:''' | ||
hypoechoic, smooth, round, and well-circumscribed mass | hypoechoic, smooth, round, and well-circumscribed mass | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Epididymal cyst | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Epididymal cyst]] | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | - | | style="background: #F5F5F5; padding: 5px; text-align: center;" | - | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/- | | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/- | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/- | | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/- | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Inguinal | | style="background: #F5F5F5; padding: 5px; text-align: center;" |[[Inguinal]] | ||
| style="background: #F5F5F5; padding: 5px; " |'''Ultrasound:''' | | style="background: #F5F5F5; padding: 5px; " |'''Ultrasound:''' | ||
posterior acoustic enhancement, well defined anechoic lesions, larger cysts may contain septations | posterior acoustic enhancement, well defined anechoic lesions, larger cysts may contain septations | ||
|} | |} | ||
== References == | |||
{{Reflist|2}} | |||
Latest revision as of 20:44, 13 February 2019
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Farima Kahe M.D. [2]
Overview
Inguinal hernia must be differentiated testicular torsion, epididymitis, hydrocele, varicocele, spermatocele, epididymal cyst and testicular tumor.
Differentiating inguinal hernia from other Diseases
- Inguinal hernia must be differentiated testicular torsion, epididymitis, hydrocele, varicocele, spermatocele, epididymal cyst and testicular tumor.[1][2][3][4]
| Diseases | Clinical features | Imaging | |||
|---|---|---|---|---|---|
| Swelling | Pain | Mass | Inguinal or scrotal | ||
| Testicular torsion | + | + | + | Scrotal | Doppler ultrasonography:
enlargement, decreased echogenicity, and absent flow |
| Epididymitis | +/- | + | - | Scrotal | Doppler ultrasonography:
enlarged (>17 mm) epididymis with a hypoechoic, hyperechoic, or heterogeneous echotexture, increased blood flow |
| Hydrocele | + | - | - | Inguinal | Ultrasound:
simple fluid collection |
| Varicocele | +/- | +/- | +/- | Inguinal | Ultrasonography:
tortuous, tubular, anechoic structures adjacent to the testis corresponding to dilated veins of the pampiniform plexus with calibers of 2–3 mm during the Valsalva maneuver |
| Spermatocele | + | - | +/- | Inguinal | Ultrasonography:
hypoechoic with posterior acoustic enhancement Color doppler ultrasonography: falling snow, resulting from internal echoes moving away from the transducer |
| Testicular tumor | +/- | +/- | + | Inguinal | Ultrasonography:
hypoechoic, smooth, round, and well-circumscribed mass |
| Epididymal cyst | - | +/- | +/- | Inguinal | Ultrasound:
posterior acoustic enhancement, well defined anechoic lesions, larger cysts may contain septations |
References
- ↑ Jenkins JT, O'Dwyer PJ (2008). "Inguinal hernias". BMJ. 336 (7638): 269–72. doi:10.1136/bmj.39450.428275.AD. PMC 2223000. PMID 18244999.
- ↑ Perrott CA (2004). "Inguinal hernias: room for a better understanding". Am J Emerg Med. 22 (1): 48–50. PMID 14724878.
- ↑ Oh SN, Jung SE, Rha SE, Lim GY, Ku YM, Byun JY, Lee JM (2007). "Sonography of various cystic masses of the female groin". J Ultrasound Med. 26 (12): 1735–42. PMID 18029925.
- ↑ Yang DM, Kim HC, Lim JW, Jin W, Ryu CW, Kim GY, Cho H (2007). "Sonographic findings of groin masses". J Ultrasound Med. 26 (5): 605–14. PMID 17460003.