Plain Films

 Not required or helpful in pediatric patients with suspected hernia

 May show free air or signs of intestinal obstruction in complicated hernias

Ultrasound

 Not used in most pediatric hernias

 May be useful in differentiating large hydroceles that extend up to external ring from incarcerated scrotal hernia sac but surgery should not be delayed for imaging if the latter is suspected

Ultrasound

 Doppler ultrasound may be utilized to detect the presence or absence of testicular blood flow in cases of suspected testicular torsion if the diagnosis is not clear

 Surgery should not be delayed for imaging if the latter diagnosis is reasonably certain

References

 Figueroa TE and Casale P. “The Acute Scrotum”. Chapter in Mattei P, Surgical Directives: Pediatric Surgery. Lippincott, Williams & Wilkins, Philadelphia, 2003.

  Leys CM and Gatti JM. “The Acute Scrotum”. Chapter in Holcomb GW and Murphy JP, Ashcraft’s Pediatric Surgery, 5th Ed. Saunders/Elsevier, Philadelphia, 2010.