Introduction
The symptoms of inguinal hernia range from painless swelling to intestinal obstruction in case of an incarcerated hernia. Sometimes there is pain in a circumscribed area without palpable hernia or swelling. In these cases, another cause (see below) should be excluded before planning the surgical treatment of the hernia.
In case of symptoms of swelling and/or pain in the groin, a hernia is always considered first, as this is the most common cause. However, these symptoms can also have other causes. Symptoms of swelling can be the expression of enlarged lymph nodes, which in turn are in most cases the result of inflammation.
Enlarged lymph nodes require further clarification in any case! After puncturing the groin vein (e.g. with a heart catheter), bruises (haematoma) may also occur, which are also noticeable as swellings. Such bruises often require surgical treatment.
Pain in the groin can be caused by an irritation of the point where the thigh muscles attach to the pelvis. This is often the case after stronger efforts of the leg muscles, e.g. after a soccer match. Another cause of groin pain are problems of the hip joint. Signs of wear and tear (“hip arthrosis“) as well as the fracture of the neck of the femur are sometimes diagnosed as the sole symptom of groin pain.
Cause
In embryos, there is a natural connection between the abdominal cavity and the groin: Processus vaginalis. If this connection does not close around birth, a congenital inguinal hernia develops. The parents observe a protrusion in the area of the groin(s) (or both), which is more pronounced when crying, due to the increased pressure in the abdominal cavity, and is painless in most cases.
Under certain circumstances, however, this protrusion can be painful (due to pressure). In these cases, at least a beginning incarceration must be assumed. In adulthood, a weaker connective tissue can favour the development of the inguinal hernia. This is often the case in older people. In young men, an inguinal hernia develops during excessive physical exertion, e.g. during heavy lifting or bodybuilding.
