How to palpate the inguinal channel | The inguinal channel

How to palpate the inguinal channel

In order to diagnose an inguinal hernia with certainty, the inguinal channel can be palpated. However, this should always be done carefully by a doctor. In men, the inguinal canal is best palpated in a standing position.

It is best to start with the scrotum and slowly and carefully palpate the inner inguinal ring with the index finger. The hernial sac can then be palpated with the tip of the finger. If this is not the case, you can ask the person affected to cough.

This increases the pressure in the abdominal cavity and usually the hernia sac comes towards the index finger and thus becomes palpable. Palpation can then cause pain for the person concerned. After palpation, an attempt can be made to return the abdominal viscera to the abdomen.

If the hernia cannot be returned, there is an urgent indication for surgery. In case of a suspected constriction and thus reduced blood flow in the intestinal loops, there is an emergency indication. In women it is not possible to palpate the inguinal canal via the inner inguinal ring. In this case only the inguinal channel can be palpated from the outside (above the inguinal ligament).

Narrowing of the inguinal canal

Narrowing in the inguinal canal can have various causes. In the context of an inguinal hernia, intestinal loops can emerge from the abdominal cavity in the inguinal canal, which leads to narrowing. In the case of a hydrocele, fluid collects in the vaginal process of the inguinal canal, which can also lead to a constriction.

In such cases, both vessels and nerves can become trapped. This can lead to reduced blood flow in some genital areas (testicles) and to nerve failure. If the ramus genitalis of the genitofemoral nerve is pinched, loss of sensitivity can occur in the skin of the scrotum and on the labia majora. If the ilioinguinal nerve is compressed, pain and problems with extension and internal rotation of the hip can be observed.