Sonographic Evaluation of an Inguinal Hernia Containing Peristalsing Bowel in an Adult Male: A Case Study

Faculty Mentor

Dr. Myka Bussey-Campblee

Location

Savannah Ballroom

Type of Research

Proposed

Session Format

Poster Presentation

College

Waters College of Health Professions

Department

Clinical Sciences

Abstract

Abstract

Inguinal hernias account for approximately 75% of abdominal wall hernias and represent a critical differential diagnosis in adult males presenting with acute scrotal pain and swelling. This case study examines the diagnostic workup of a 46-year-old male presenting to the emergency department with right sided groin pain and inflammation. Laboratory assessment could include a Complete Blood Count (CBC) with a focus on the neutrophil-to-lymphocyte ratio (NLR) to evaluate systemic inflammation; however, our patient did not have this done. Sonographic imaging was performed using a GE LOGIQ E10 system with a wideband matrix linear array probe (ML6-15D). While the examination revealed a small 4mm epididymal cyst, testicular perfusion and morphology were unremarkable, ruling out torsion. The primary finding was a right inguinal hernia containing fluid and viable, peristalsing bowel loops. The presence of peristalsis was a critical sonographic indicator, distinguishing the pathology from a strangulated hernia or complex hydrocele. This case highlights the utility of high-frequency ultrasound in anatomically characterizing inguinal masses and verifying bowel viability to guide appropriate surgical intervention.

Keywords: inguinal hernia, scrotal ultrasound, neutrophil-to-lymphocyte ratio (NLR), peristalsis, Heselbach's triangle.

Program Description

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Start Date

4-21-2026 1:30 PM

End Date

4-21-2026 3:30 PM

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Apr 21st, 1:30 PM Apr 21st, 3:30 PM

Sonographic Evaluation of an Inguinal Hernia Containing Peristalsing Bowel in an Adult Male: A Case Study

Savannah Ballroom

Abstract

Inguinal hernias account for approximately 75% of abdominal wall hernias and represent a critical differential diagnosis in adult males presenting with acute scrotal pain and swelling. This case study examines the diagnostic workup of a 46-year-old male presenting to the emergency department with right sided groin pain and inflammation. Laboratory assessment could include a Complete Blood Count (CBC) with a focus on the neutrophil-to-lymphocyte ratio (NLR) to evaluate systemic inflammation; however, our patient did not have this done. Sonographic imaging was performed using a GE LOGIQ E10 system with a wideband matrix linear array probe (ML6-15D). While the examination revealed a small 4mm epididymal cyst, testicular perfusion and morphology were unremarkable, ruling out torsion. The primary finding was a right inguinal hernia containing fluid and viable, peristalsing bowel loops. The presence of peristalsis was a critical sonographic indicator, distinguishing the pathology from a strangulated hernia or complex hydrocele. This case highlights the utility of high-frequency ultrasound in anatomically characterizing inguinal masses and verifying bowel viability to guide appropriate surgical intervention.

Keywords: inguinal hernia, scrotal ultrasound, neutrophil-to-lymphocyte ratio (NLR), peristalsis, Heselbach's triangle.