Incarcerated inguinal hernia — RACP Paediatrics MCQ

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ModerateEmergencyIncarcerated inguinal herniaRACP Paediatrics

A 3-month-old presents with irritability, vomiting, and a firm, tender, irreducible lump in the right inguinal region. The ipsilateral testis is difficult to palpate separately. What is the most likely diagnosis?

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Correct answer: B — Incarcerated inguinal hernia

An irreducible, tender inguinal mass in an infant is an incarcerated inguinal hernia until proven otherwise. This is a surgical emergency as bowel ischaemia can develop. Manual reduction under sedation should be attempted if the infant is not peritonitic. Urgent surgical repair is required. Testicular ischaemia is also a risk (hernia compressing testicular vessels).

Reference: RCH Melbourne – 2023 – Inguinal Hernia CPG; RACP Paediatric Curriculum – Emergency