Reversible mass in the groin area
Introduction
Introduction Inguinal hernia is a reversible mass in the inguinal region. The initial mass is small. It only appears when the patient is standing, working, walking, running, coughing or crying. When lying down or pressing by hand, the swollen body can be returned by itself. It is more common to disappear from the right inguinal hernia. Generally no special discomfort, only occasionally with local pain and pain. As the disease progresses, the mass can gradually increase, from the groin to the scrotum or the labia majora, inconvenient walking and affect labor. The mass is in the shape of a pear with a pedicle, the upper end is narrow and the lower end is wide.
Cause
Cause
1. The fetal peritoneal sheath is not locked and communicates with the abdominal cavity to become a congenital hernia sac. The intra-abdominal organ or tissue can easily form a oblique sac from the residual peritoneal sheath through the inguinal canal.
2, women have uterine round ligaments through the inguinal canal, so there is a similar peritoneal protuberance and fall into the labia majora, such as unobstructed can also form a squat.
3. In addition, congenital dysplasia leading to defects in the physiological masking mechanism of the inguinal canal is also one of the important causes of inguinal hernia.
Examine
an examination
Related inspection
Laparoscopic abdominal vascular ultrasound examination of ascites
symptom
1, easy to relapse clinical symptoms may vary depending on the size of the sac or with or without complications. The basic symptom is that there is a reversible mass in the inguinal region. The initial mass is small. It only appears when the patient is standing, working, walking, running, coughing or crying. When lying down or pressing by hand, the swollen body can return itself. Disappear. Generally no special discomfort, only occasionally with local pain and pain. As the disease progresses, the mass can gradually increase, from the groin to the scrotum or the labia majora, inconvenient walking and affect labor. The mass is in the shape of a pear with a pedicle, the upper end is narrow and the lower end is wide.
2, difficult to remove the oblique sputum in terms of clinical performance in addition to slightly heavier pain, its main feature is that the sputum can not be completely returned.
3, incarceration often occurs in strong labor or defecation, such as sudden increase in intra-abdominal pressure, usually oblique. Clinically, it is often manifested by a sudden increase in the mass of the sputum, accompanied by significant pain. Lying in the flat or by hand can not be returned. The mass is tight and stiff and has obvious tenderness. The incarcerated content is the omentum, local pain is often mild; if it is intestinal fistula, not only local pain, but also accompanied by paroxysmal abdominal cramps, nausea, vomiting, constipation, abdominal distension and other mechanical intestinal obstruction Disease image. Once incarcerated, the chance of self-return is small; the symptoms of most patients gradually increase, and if not treated in time, it will eventually become a strangulated sputum. When the intestinal wall is incarcerated, because the local mass is not obvious, it does not necessarily have intestinal obstruction and is easily ignored.
Diagnosis
Differential diagnosis
Differential diagnosis of reversible mass in the inguinal region:
1. Testicular hydrocele: The positive test of the light transmission of the tumor is a characteristic clinical manifestation of this disease. In addition, the mass has a clear boundary, and the upper pole does not meet the outer ring. Testicles are not easily covered if they are covered by hydrocele. The mass can not be returned, and there is no history of reversible disease. If the peritoneal sheath is not completely closed and the traffic testicular hydrocele is formed, although the mass has reversible characteristics, it can be identified by light transmission test.
2. Uterine round ligament cyst: The mass is located in the inguinal canal, which is round or elliptical. It has a sexy capsule with clear boundary and high tension. Its upper end does not extend into the abdominal cavity, and it is generally not easy to be confused with sputum.
3. The spermatic cyst or the testicular insufficiency: the mass is located in the inguinal canal or the spermatic testis, and the boundary is clear. The former has a sac sexy, high tension, the same scrotum can be found in the same side of the testis, the latter is tough, for the sense of substance, the same side of the scrotum testicular absent.
In fact, the differential diagnosis is not difficult. The basic characteristics shared by the above diseases are: non-reversible masses, the upper boundary of the mass does not enter the outer ring or the inner ring, and there is no "bow handle", and there is no cough impact.
