Differential diagnosis Although the diagnosis of inguinal hernia is relatively easy, it needs to be differentiated from the following common diseases. 1. testicular syringomyelia The mass presented by syringomyelia is completely confined to the scrotum and its upper border can be clearly palpated; when the mass is examined by transillumination test, syringomyelia is mostly transilluminating (positive), whereas the hernia mass is not transilluminating. It should be noted that hernia masses in young children are often translucent because of the thin tissue and should not be confused with syringomyelia. In inguinal hernia, the parenchymal testicle can be found behind the mass; in syringomyelia, the testicle is in the middle of the fluid, so all sides of the mass are cystic and the parenchymal testicle cannot be found. 2.Traffic syringomyelia The shape of the mass is similar to that of testicular syringomyelia. The mass appears slowly and increases in size after waking up or during standing activities every day. The mass gradually shrinks after lying down or sleeping, and its volume may also gradually decrease when squeezing the mass. The transillumination test is positive. 3.Spermatic cord sheath effusion The mass is small and is in the inguinal canal. The mass can be seen to move by pulling the ipsilateral testicle. 4.Cryptorchidism A testicle with incomplete descent in the inguinal canal can be misdiagnosed as hiatal hernia or spermatic sphincter effusion. The mass of cryptorchidism is small, and when squeezed, a characteristic swelling and painful sensation may appear. If the testicle is absent in the scrotum on the affected side, the diagnosis is more clear. Acute intestinal obstruction A hernia with an embedded intestinal canal may be accompanied by acute intestinal obstruction, but the diagnosis of intestinal obstruction should not be satisfied with the presence of hernia; especially if the patient is obese or the hernia mass is small, such problems are more likely to occur and lead to treatment errors.