Inguinal hernia typically presents with a bulge or swelling in the groin area, which may become more prominent when standing, coughing, or straining. Patients often describe discomfort or pain in the groin, especially during activities that increase intra-abdominal pressure, such as lifting heavy objects. The bulge may disappear when lying down or gently pushing it back into the abdomen (reducible hernia). Occasionally, individuals may experience a feeling of heaviness or pressure in the groin and lower abdomen. In some cases, inguinal hernias can lead to complications such as incarceration or strangulation, characterized by severe pain, nausea, vomiting, and inability to push the hernia back in.

Clinical findings of inguinal hernias typically include a palpable bulge or swelling in the groin area, which may be more noticeable when the individual stands, coughs, or strains. The bulge often disappears when the person lies down or when it can be gently pushed back into the abdomen (reducible hernia). Patients commonly report discomfort or pain in the groin region, particularly during activities that increase intra-abdominal pressure. Physical examination may reveal a soft, non-tender bulge in the inguinal canal or scrotum, depending on the type of hernia (indirect or direct). In some cases, auscultation over the hernia site may reveal bowel sounds if the hernia contains intestine. Prompt diagnosis and appropriate management are crucial to prevent complications such as incarceration or strangulation, which can present with severe pain, nausea, vomiting, and signs of bowel obstruction.

In Sub-Saharan Africa, investigations for inguinal hernias typically include clinical examination, ultrasound, and sometimes X-ray or computed tomography (CT) scan to confirm diagnosis and assess complications. Clinical examination by trained healthcare providers remains essential for initial assessment, differentiation from other conditions, and evaluation of hernia characteristics such as reducibility and signs of incarceration or strangulation. Ultrasound is widely used for its ability to provide detailed images of hernia sacs and contents, aiding in accurate diagnosis. In more complex or uncertain cases, imaging modalities like CT scans may be utilized to further evaluate hernia anatomy and guide surgical planning. Access to these investigations can vary based on healthcare resources, emphasizing the importance of tailored diagnostic approaches to manage inguinal hernias effectively in the region.

In Sub-Saharan Africa, differential diagnoses of inguinal hernias include conditions such as hydrocele, inguinal lymphadenopathy, testicular tumours, spermatocele, and femoral hernias. These conditions can mimic inguinal hernias but are differentiated by specific clinical features, such as transillumination in hydroceles, inflammatory characteristics in lymphadenopathy, solid mass characteristics in testicular tumours, and the absence of reducibility and bowel sounds in spermatoceles. Femoral hernias, though less common, present with a bulge in the upper thigh and require careful examination to distinguish from inguinal hernias. Accurate diagnosis is essential for appropriate management and treatment planning.

In Sub-Saharan Africa, the treatment of inguinal hernias primarily involves surgical repair, often performed through open or laparoscopic techniques under local or regional anaesthesia. Surgical outreach programs play a vital role in delivering care to underserved communities where access to healthcare facilities is limited. Public health efforts focus on educating communities about hernia symptoms and encouraging timely medical intervention.

Following up on inguinal hernias in Sub-Saharan Africa involves regular post-operative assessments to monitor recovery and detect complications early. Patients are educated on proper wound care and signs of complications, emphasizing the importance of seeking medical help promptly. Long-term surveillance may be recommended to monitor for hernia recurrence. Community engagement plays a vital role in reinforcing follow-up care and promoting awareness about hernia management. These efforts aim to improve surgical outcomes and reduce the impact of inguinal hernias in resource-limited settings.

Prevention and control of inguinal hernias in Sub-Saharan Africa involve educating communities on risk factors and promoting proper lifting techniques and nutritional practices. Improving access to healthcare facilities and ensuring timely surgical intervention are critical in reducing hernia incidence and complications. Implementing occupational safety measures and conducting public health campaigns help raise awareness and encourage early medical consultation. Research to inform evidence-based policies and interventions is essential for effectively managing and reducing the burden of inguinal hernias in the region.