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Inguinal Hernia J003

Document
Last amended 
26 April 2016
Current RMA Instruments:
Reasonable Hypothesis SOP 5 of 2013
Balance of Probabilities SOP
6 of 2013
Changes from previous Instruments:

SOP Bulletin 163

ICD Coding:
  • ICD-9-CM Codes: 550
  • ICD-10-AM Codes: K40
Brief description

This condition presents as a lump in the groin. It can be painless or painful and the lump may be present intermittently or all the time. It is a protrusion of abdominal contents through the abdominal wall at the groin (at the inguinal canal). This can be just fat from the abdominal cavity or include a loop of bowel. If bowel is included there is a risk that the bowel can be trapped (incarcerated) with consequent bowel obstruction; or the bowel blood supply compromised (strangulated), leading to the infarction of the bowel and on retraction of the dead bowel into the peritoneal cavity, peritonitis.

Confirming the diagnosis

An inguinal hernia is diagnosed clinically from the history and findings on examination.  

The appropriate medical specialist is a general surgeon.

Conditions excluded from SOP
  • Femoral hernia#
  • Hiatus hernia*
  • Incisional hernia(under investigation by RMA as at Apr 2016)
  • Obturator hernia#
  • Sportsman’s or Sports hernia, This is not a true hernia but a tear in the abdominal fascia.
  • Umbilical and paraumbilical hernia# (under investigation by RMA as at Apr 2016)
  • Ventral hernia (under investigation by RMA as at Apr 2016)

* another SOP applies  - the SOP has the same name unless otherwise specified

# non-SOP condition

Clinical onset

The condition may be asymptomatic and may be found incidentally at examination.  More usually, a lump / buldge in the groin is noticed.  There may be discomfort with coughing, exercise, or bowel movements.  Hernias are rarely painful. Once diagnosis has been confirmed clinical onset can be backdated to when the lump first became noticable.

Clinical worsening

The normal course for a hernia is to remain fairly stable or slowly progress.  Serious complications can develop in a small proportion of cases.  Treatment may be conservative or surgery may be required.  Worsening could be evidenced by sudden progression or the development of complications.