Tender inguinal swelling in female infants and children: Diagnostic approach

In girls, tender inguinal swelling is caused by an incarcerated or strangulated inguinal hernia, cellulitis, or lymphadenitis. Because incarcerated or strangulated indirect inguinal hernias in females frequently contain reproductive organs (eg, ovary or fallopian tube), the clinician should attempt a gentle reduction and then obtain an emergency Doppler ultrasound (US) if not successful. If the US shows that reproductive organs are not present, then further efforts at reduction are appropriate. Emergency surgical consultation is warranted for hernias containing a torsed ovary and unreducible indirect and femoral hernias. This algorithm is intended for use in conjunction with additional UpToDate content. For more details, refer to UpToDate topics on inguinal swelling in children.