Hernias Workup

  • Author: Bret A Nicks, MD; Chief Editor: Steven C Dronen, MD, FAAEM   more...
 
Updated: Jan 25, 2010
 

Laboratory Studies

  • Complete blood count
    • Results from CBC are nonspecific
    • Leukocytosis with left shift may occur with strangulation
  • Electrolytes, BUN, creatinine levels
    • Assess the hydration status of the patient with nausea and vomiting
    • These tests are rarely needed for patients with hernia except as part of a preoperative workup
  • Urinalysis: This test assists with narrowing the differential diagnosis of genitourinary causes of groin pain in the setting of associated hernias.
Next

Imaging Studies

  • Imaging studies are not required in the normal workup of a hernia.[4, 6]
  • Ultrasonography can be used in differentiating masses in the groin or abdominal wall or in differentiating testicular sources of swelling.
  • If an incarcerated or strangulated hernia is suspected, the following imaging studies can be performed:
    • Upright chest radiograph to exclude free air (extremely rare)
    • Flat and upright abdominal films to diagnose a small bowel obstruction (neither sensitive or specific) or to identify areas of bowel outside the abdominal cavity
  • CT scanning or ultrasonography may be necessary in the following cases:
    • To diagnose a spigelian or obturator hernia
    • Inability to obtain a good examination because of body habitus
Previous
Proceed to Treatment & Management
 
 
Contributor Information and Disclosures
Author

Bret A Nicks, MD  Assistant Professor, Assistant Medical Director, Department of Emergency Medicine, Wake Forest University Health Sciences

Bret A Nicks, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, Christian Medical & Dental Society, Society for Academic Emergency Medicine, and Wilderness Medical Society

Disclosure: Nothing to disclose.

Coauthor(s)

Kim Askew, MD  Assistant Professor, Department of Emergency Medicine, Wake Forest University School of Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Richard Lavely, MD, JD, MS, MPH  Lecturer in Health Policy and Administration, Department of Public Health, Yale University School of Medicine

Richard Lavely, MD, JD, MS, MPH is a member of the following medical societies: American College of Emergency Physicians, American College of Legal Medicine, and American Medical Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Eugene Hardin, MD, FAAEM, FACEP  Former Chair and Associate Professor, Department of Emergency Medicine, Charles Drew University of Medicine and Science; Former Chair, Department of Emergency Medicine, Martin Luther King Jr/Drew Medical Center

Disclosure: Nothing to disclose.

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Steven C Dronen, MD, FAAEM  Director of Emergency Services, Director of Chest Pain Center, Department of Emergency Medicine, Ft Sanders Sevier Medical Center

Steven C Dronen, MD, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

References

  1. Eubanks S. Hernias. In: Sabiston DC Jr, ed. Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 1997.

  2. Katz DA. Evaluation and management of inguinal and umbilical hernias. Pediatr Ann. Dec 2001;30(12):729-35. [Medline].

  3. Levine BJ, Nabha S, Bouzoukis JK. Chronic inguinal hernia. J Emerg Med. May-Jun 1999;17(3):515-6. [Medline].

  4. Matthews RD, Neumayer L. Inguinal hernia in the 21st century: an evidence-based review. Curr Probl Surg. Apr 2008;45(4):261-312. [Medline].

  5. Scherer LR 3d, Grosfeld JL. Inguinal hernia and umbilical anomalies. Pediatr Clin North Am. Dec 1993;40(6):1121-31. [Medline].

  6. Bobrow RS. The hernia. J Am Board Fam Pract. Jan-Feb 1999;12(1):95-6. [Medline].

  7. Wants GE. Abdominal wall hernias. In: Schwartz SI, Shires GT, Spencer FC, eds. Principles of Surgery. 6th ed. 1994.

  8. Mensching JJ, Musielewicz AJ. Abdominal wall hernias. Emerg Med Clin North Am. Nov 1996;14(4):739-56. [Medline].

  9. Manthey DE. Abdominal hernia reduction. In: Clinical Procedures in Emergency Medicine. 2003.

  10. Brandt ML. Pediatric hernias. Surg Clin North Am. Feb 2008;88(1):27-43, vii-viii. [Medline].

  11. Rutkow IM, Robbins AW. Demographic, classificatory, and socioeconomic aspects of hernia repair in the United States. Surg Clin North Am. Jun 1993;73(3):413-26. [Medline].

  12. Rutkow IM. Epidemiologic, economic, and sociologic aspects of hernia surgery in the United States in the 1990s. Surg Clin North Am. Dec 1998;78(6):941-51, v-vi. [Medline].

  13. Kapur P, Caty MG, Glick PL. Pediatric hernias and hydroceles. Pediatr Clin North Am. Aug 1998;45(4):773-89. [Medline].

  14. Akbulut S, Cakabay B, Sezgin A. A familial tendency for developing inguinal hernias: study of a single family. Hernia. Aug 29 2009;[Medline].

  15. Smith S. Inguinal hernia reduction. In: King C, Henretig FM, eds. Textbook of Pediatric Emergency Procedures. 2nd ed. Philadelphia, PA: Lippincott Williams and Wilkins; 2008:840-847/87.

  16. Ginsburg BY, Sharma AN. Spontaneous rupture of an umbilical hernia with evisceration. J Emerg Med. Feb 2006;30(2):155-7. [Medline].

 
Previous
Next
 
Anatomic locations for various hernias.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.