Inguinal hernia differential diagnosis
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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 | Imagings | |||
|---|---|---|---|---|---|
| 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 |
- ↑ 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.