Surgery Book

Gastroenterology

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Groin Disruption

Aka: Groin Disruption
  1. See Also
    1. Groin Injuries in Athletes
    2. Sports Hernia
  2. Pathophysiology
    1. More diverse posterior wall defects than Sports Hernia
    2. Posterior abdominal wall abnormality or tear
      1. External oblique aponeurosis tear
      2. Conjoined tendon tear
      3. Dehiscence of conjoined and inguinal ligament
      4. Rectus abdominis Muscle tears
  3. Symptoms
    1. Exertion Groin Pain
    2. Provocative
      1. Valsalva Maneuver provokes pain in only 10% of cases
      2. Pain on resisted adduction of hip (65%)
      3. Half sit-ups
      4. Increased intra-abdominal pressure
  4. Signs
    1. Inguinal Hernia not detectable (affects posterior wall)
    2. Difficult to diagnose except during surgery
  5. Differential Diagnosis
    1. Sports Hernia
      1. Lateral and superior to Groin Disruption
  6. Radiology
    1. Imaging rules out other diagnoses
  7. Management
    1. Conservative therapy trial for 2-3 weeks
    2. Surgical exploration if conservative therapy fails
      1. Successful return to sport in 90% of cases
  8. References
    1. Schleihauf (2019) Crit Dec Emerg Med 33(5): 19-28
    2. Morelli (2001) Am Fam Physician 64(8):1405-14 [PubMed]

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