If an inguinal hernia is suspected, how does a doctor usually examine to confirm the presence or absence of a hernia? Unlike other diseases, the diagnosis of an inguinal hernia is usually very intuitive. The presence of a history of inguinal masses that are “sporadic” and “sometimes large and sometimes small”, such as a mass that appears when standing and disappears after resting, together with a professional physical examination by a doctor, can basically clarify the situation. Is a lump in the groin necessarily a hernia? I should say not necessarily, but it is very likely. In general, the most common manifestation of an inguinal hernia is the presence of a lump in the inguinal region. However, there are other possibilities for inguinal masses. Enlarged lymph nodes in the inguinal region, lipomas, spermatic cord cysts in men, and round ligament cysts in the uterus in women all present as a mass in the inguinal region. However, the difference is that inguinal hernia masses generally have a special phenomenon, which is medically called “reversible masses”: they protrude when standing and are accompanied by a soreness and swelling, which disappears or shrinks significantly when lying down, and the soreness and swelling are relieved. The patient may describe to the doctor that the lump is like playing hide-and-seek with himself, “sometimes absent”, “sometimes big, sometimes small”. Of course, with the prolongation and development of the disease, the mass of the hernia may also appear to “push back” over time. In addition, if an acute complication of the hernia occurs – entrapment – the mass is no longer “reducible” and is accompanied by significant pain, even abdominal pain, bloating, vomiting and other signs of intestinal obstruction. However, with the increase in the weight of the population (it can’t be helped, as the standard of living increases, more and more fat people are becoming fat) and the thickening of the subcutaneous fat layer of the abdominal wall, the diagnosis of inguinal hernia is not easy in individual cases. In addition, some patients have obvious soreness and swelling in the inguinal region when standing or walking, but physical examination does not reveal an obvious mass protruding, so is there a hernia or not? At this time, it is difficult to determine this by clinical symptoms and physical examination alone. Some early, small hernias do show this, and we call them occult hernias. However, diseases such as varicocele can also have the same symptoms. This is when ultrasound is needed to identify them for the doctor. Of course, if the ultrasound may not be able to confirm the diagnosis of these occult hernias, it is perfectly acceptable to observe them clinically for a period of time and then operate when the hernia becomes more obvious and can be confirmed. If the patient happens to have surgery on one side of the hernia, then laparoscopic observation of the other side is often the most reliable basis for diagnosis. The easiest and most effective way to diagnose an inguinal hernia, other than a specialist physical examination, is ultrasound. Some patients think that expensive CT or MRI examinations should be more effective, but they are not. The inguinal hernia lesion is superficial and varies greatly with body position. CT and MRI, on the other hand, because the patient has to lie down during the examination, the protruding hernia mass is often incorporated into the abdominal cavity, which makes it easy to miss the diagnosis. Therefore, the doctor will not ask you to do ultrasound to save money and trouble, but to make a more accurate diagnosis.