POCUS can help you identify signs of a hernia.
Begin by asking the patient to localize the point of maximal tenderness, then place a linear or curvilinear transducer over the area of concern. If there is concern for an inguinal hernia, you can have the patient perform a Valsalva maneuver while holding the probe in the area to evaluate dynamic changes.
A hernia is diagnosed when omental fat or intestinal contents are seen protruding through a defect in the abdominal wall.
If you are concerned about an incarcerated hernia, sonographic findings may include absence of peristalsis, presence of surrounding free fluid, with preserved blood flow on color Doppler. If a hernia progresses to strangulation, you may notice the absence of flow on color and power Doppler.
Boccatonda A, Brighenti A, Tiraferri V, Doglioli M, Iazzetta L, De Meis L, Safai Zadeh E, Dietrich CF, Serra C. POCUS for acute abdominal pain: practical scan protocols on gastrointestinal diseases and an evidence review. J Ultrasound. 2025 Dec;28(4):851-871. doi: 10.1007/s40477-025-01088-7.
