How is an inguinal hernia distinguished from a hydrocele?

Updated: Oct 28, 2020
  • Author: Jacob C Parke, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

While laboratory studies are not warranted in routine inguinal herniorrhaphy, a possible incarcerated inguinal hernia may be difficult to distinguish from a hydrocele.

Findings that may favor urgent exploration in this setting include the following:

  • Failure to clearly transilluminate
  • Palpable bowel at the internal ring during the rectal examination
  • An elevated white blood cell count

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