How Are Hernias Diagnosed?

Hernias can, on occasions, be difficult to diagnose. They can be present and then disappear. When this happens, the hernia does not repair itself, rather, the hernia defect, or hernia sac, simply goes back inside your abdomen through the same weakness in the abdominal wall – the weakness however, remains until it is surgically repaired.

Hernias may be identified by Ultrasound, CT scan or MRI (all of which are rarely needed) but the most reliable way is by a physical exam by a surgeon experienced in hernia repair. Diagnostic imaging “may” show that there are protrusions in the abdominal wall, but they cannot always differentiate the size of the actual hernia defect, or, whether the protrusion is a hernia versus a natural fold of the abdominal wall. Shouldice surgeons see hundreds of patients a year where initial diagnosis based on imaging confirmed the existence of a hernia, when in fact no hernia was clinically present. In these cases it may be better to wait and see if an actual hernia presents itself rather committing to unnecessary surgery.

As well, the absence of a hernia on a diagnostic image does not in itself mean there is no hernia, as surgeons at Shouldice encounter cases where imaging was negative for a hernia when, in fact, a hernia was present on examination.