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Differential diagnosis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

The differential diagnosis of an inguinal hernia in a male is:

  • hydrocoele of processus vaginalis
  • hydrocoele of spermatic cord
  • spermatocoele
  • varicocoele
  • undescended testis - inguinal hernia often occurs in association with this condition
  • lipoma of spermatic cord or herniation of properitoneal fat into the cord through the inguinal ring

In females, consider:

  • hydrocoele of canal of Nuck

For both sexes, consider also:

  • femoral hernia - these may extend above the inguinal ligament after passing through the fossa ovalis femoris. But, if the examining finger is placed on the pubic tubercle, the neck of a sac of a femoral hernia lies lateral and below, whilst that of an inguinal lies above.
  • lymphadenopathy or abscesses of the groin
  • residual haematoma following trauma or spontaneous haemorrhage in patients taking anti-coagulants

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