Inguinal Hernia
photo by Janelle Aby, MD
This is a typical appearance of bilateral inguinal hernias. In contrast to hydrocele, inguinal hernias are associated with a fullness in both the inguinal area and the scrotum and can usually be reduced with digital pressure. At times bowel sounds may even be appreciated over the area of the mass. This infant is preterm, a risk factor for the presence of hernias. While the scrotum may transilluminate with either hydrocele or hernia, other clinical features will usually differentiate the two conditions. The presence of unilateral or bilateral hernias does not automatically preclude circumcision, but careful evaluation should be done. If the hernias are sufficiently large to encroach on the penile shaft (as appears to be the case in the infant above) then circumcision should be delayed.
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