Since hernias are external or internal protrusions of body parts due to a combination of defected muscle tissue and increased internal body pressure, the two most common methods to test and diagnose hernias are physical exams and X-ray imaging. Depending on the anatomical region of the affected area, physicians may perform additional diagnostic testing to rule out other more serious medical conditions unrelated to hernias.
A physical exam is often the first line of testing to diagnose external hernias. The physician usually palpates the affected bulge for the texture, size and fullness of the protrusion. He or she will also visually evaluate the protrusion for discolorations, since inflammation or abnormally dark blotches may signify infection or gangrene, a life-threatening condition involving tissue necrosis. Questions regarding symptoms present in hernias may also be asked. Physical exams are commonly used in the diagnosis of external hernias such as the following:
For hernias that occur internally or that cannot be determined from a physical exam, diagnostic X-ray and imaging would be performed to confirm the presence of a hernia. X-rays are also used for external protrusions when the doctor suspects the presence of a body organ in the hernia. Since internal hernias often share similar symptoms with other unrelated medical conditions, it is important to confirm the diagnosis before implementing any form of treatment. A common type of X-ray would be the multi detector CT (MDCT), which can clearly show the contents of the sac and its exact anatomical location. Common examples of internal hernias that require X-ray diagnosis include the following:
Depending on the anatomical site of the hernia and the seriousness of the case, doctors may choose to perform additional testing to further confirm the diagnosis. One example would be performing an endoscopy, which would involve directly inserting an endoscope into the suspected body cavity to examine the internal organs at the affected site.
Laboratory testing can also be used to eliminate other suspecting medical conditions, as well as to confirm the severity of the hernia. Blood tests that perform a white blood cell count can detect inflammation, infection and presence of tissue necrosis, while a complete red blood cell count can detect internal blood loss or circulation blockage. For diaphragmatic hernias, a pH test can identify the presence of stomach ulcers, which is one of the consequences of untreated internal abdominal hernias. A stool sample can also be taken to test for strangulation of abdominal organs in the hernia protrusion, since irregular bowel activity is often a symptom of intestinal incarceration. Biopsies, which involve tissue sampling at the hernia protrusion, can further help rule out other more serious conditions, such as tumors or cancer.
It is important to see a licensed physician to correctly diagnose the appearance of hernia, since some internal hernias share symptoms with other unrelated medical conditions that require completely different forms of treatment. Some of such conditions include but are not limited to the following: