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Inguinal Hernia J003

Last amended 
11 May 2021
Current RMA Instruments
Reasonable Hypothesis SOP 47 of 2021
Balance of Probabilities SOP
48 of 2021
Changes from previous Instruments

SOP Bulletin 221

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*
  • Obturator hernia#
  • Sportsman’s or sports hernia, This is not a true hernia but a tear in the abdominal fascia.
  • Umbilical and paraumbilical hernia*
  • Ventral hernia - may be covered by incisional hernia SOP or may be non-SOP depending on type/cause 

* another SOP applies 

# 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.