Physical exam for inguinal hernia

Inguinal hernias usually are easy to diagnose if you or your child has a bulge in the groin area and other symptoms (such as groin pain and tenderness) that commonly occur with inguinal hernias.

During the physical exam, you or your child will be examined while standing and while coughing or straining (as if trying to have a bowel movement). In addition, the doctor will examine the hernia and the tubular passage through the lower layers of the abdominal wall (inguinal canal). The doctor also will do this exam while you or your child is lying down.

Diagnosing an inguinal hernia in a child may be difficult. A child may not be able to cough or strain to make the hernia bulge.

• If your child is old enough, the doctor may ask him or her to cough, blow up a balloon, or jump up and down to make the hernia bulge.
• In the case of an infant, the doctor may raise the infant's arms above the head, causing the infant to struggle. This will increase the pressure within the abdomen and cause the hernia to bulge.

Parents may see a hernia bulge when their child cries or moves around actively. Reporting this to the doctor helps with the diagnosis.

It can be hard to distinguish hernias that cause a bulge in the groin area (direct hernias) and hernias that go into the scrotum (indirect hernias) during a physical exam.

If a hernia is not seen during a physical exam, a follow-up exam or further testing may be needed. If a follow-up exam is planned, you may need to watch for signs of incarceration, such as vomiting, swelling in the groin, and severe pain in the groin.