“Occult” inguinal hernias

[Topochico]

I have a mass on my left groin that is only easily palpated/visible laying down.

Occasionally there will be no mass palpable. It can get to be about the size of a golf ball, and can be quite long at times (inches). Sometimes it will feel harder than other times. Other times can be very small or basically gone

There is also a non visible small (small grape sized) lump on the right groin.

Both are non existent upon standing. I am a thin/athletic build.

Both appear in the inguinal area. Both higher than the pubic region.

I have had pain on/off in both groins for years. But not until recently noticed any lumps.

I have gone to a physician who could not find any hernias and said it’s probably my muscles or something else (it isn’t).

I get an ache and sometimes a burning sensation on either side. I have had a burning zipper sensation a couple of times on my right side. Occasionally part of the groin will have an area that is tender to touch.

95% of the time I have little to no symptoms. I am fairly active but have cut back on things like heavy lifting etc

My question is: what is the best approach to finding hard to find hernias? I want to find a physician who will work with me to find out what is going on

[drtowfigh]

– careful examination by a hernia specialist
– Ultrasound
– MRI

[Topochico]

@drtowfigh thank you so much for your prompt reply. Is there a specific protocol for ultrasound that needs to be requested?

After using the the search feature, I found this thread[0] which describes a protocol used for MRI of occult hernias. Unfortunately the image you posted back then (of the protocol) is blurry. Is there anywhere else I can view the MRI protocol?

Lastly, do you/does your practice deal with many occult hernia patients?

[0] https://herniatalk.com/forums/topic/mri-protocol-in-radiology-language-for-putting-codes-into-the-mri-machine/

[drtowfigh]

Inguinal hernias should be ordered as “hernia ultrasound” or “dynamic hernia ultrasound.”

Occult hernias are among my surgical interests. Yes, I evaluate for an treat many and I have published our experience about imaging and occult hernias.

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