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Classification, clinical features and diagnosis of inguinal and femoral hernias in adults

David C Brooks, MD
Mary Hawn, MD
Section Editor
Michael Rosen, MD
Deputy Editor
Wenliang Chen, MD, PhD


Hernias are among the oldest recorded afflictions of mankind. A hernia is defined as a protrusion, bulge or projection of an organ or a part of an organ through the body wall that normally contains it. Collectively, inguinal and femoral hernias are known as groin hernias. Inguinal hernia is more common than femoral hernia and other abdominal wall hernias (eg, umbilical, epigastric), but femoral hernias present with complications more often [1].

The classification, epidemiology, clinical features, and diagnosis of inguinal and femoral hernias will be reviewed. The management of groin hernias (nonsurgical and surgical) is discussed elsewhere. (See "Overview of treatment for inguinal and femoral hernia in adults" and "Open surgical repair of inguinal and femoral hernia in adults" and "Laparoscopic inguinal and femoral hernia repair in adults".)

Inguinal hernias in children and abdominal wall hernias are reviewed separately. (See "Overview of inguinal hernia in children" and "Overview of abdominal wall hernias in adults".)


Groin hernias (inguinal or femoral hernia) were the third leading cause of ambulatory care visits for gastrointestinal complaints in 2004 and visit rates have not changed appreciably since 1975 [2]. The prevalence of groin hernias is estimated to be between 5 and 10 percent in the United States. Inguinal hernia is more common than femoral hernia and other abdominal wall hernias (eg, umbilical, epigastric) [1]. Although femoral hernias account for less than 10 percent of groin hernias, they present clinically with complications (incarceration, strangulation) more often than inguinal hernias. (See 'Clinical features' below.)

Hernias are more common in men compared with women, and in whites compared with non-whites [2,3]. Men are eight times more likely to develop a hernia and 20 times more likely to need a hernia repair compared with women [4,5]. The lifetime risk of developing a groin hernia is about 25 percent in men but less than 5 percent in women. Women manifest groin hernias at a later age. In one review, the median age at presentation was 60 to 79 years of age for women compared with 50 to 69 years of age for men [6]. The peak age range at presentation for indirect hernia in women is 40 to 60 years of age [6] (See 'Clinical features' below.)


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Literature review current through: Sep 2016. | This topic last updated: Feb 4, 2016.
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