Tender inguinal swelling in male infants and children: Diagnostic approach

In male children, a painful inguinal lump may indicate an incarcerated or strangulated inguinal hernia, lymphadenitis, torsion of an undescended testis, or when occurring after major genitourinary trauma, testicular dislocation. Patients with incarcerated inguinal or femoral hernias should undergo prompt manual reduction followed by elective surgical repair. Emergency surgery is necessary for incarcerated indirect or femoral hernias that cannot be manually reduced or for strangulated hernias with signs of bowel obstruction. Emergency surgical consultation is also indicated for patients with testicular dislocation or torsed undescended testis. This algorithm is intended for use in conjunction with additional UpToDate content. For more details, refer to UpToDate topics on inguinal swelling and inguinal hernias in children.