Name of the Condition

• Unilateral Inguinal Hernia, Without Obstruction or Gangrene, Recurrent
• Medical term: Recurrent inguinal hernia

Summary

Unilateral inguinal hernia is a common condition where a portion of the intestine protrudes through a weakness in the abdominal muscles in the groin area. When described as "recurrent," it indicates that the hernia has returned after a previous surgical repair.

Causes

• Persistent weakness in the abdominal wall
• Straining during physical activity or bowel movements
• Previous surgical repairs that have failed

Risk Factors

• Being male (inguinal hernias are more common in men)
• Previous history of hernia
• Chronic cough or constipation
• Heavy lifting
• Smoking

Symptoms

• A bulge in the groin or scrotum that may become more apparent when coughing or straining
• A dull ache or pain in the groin area
• A sense of weakness, heaviness, or burning in the groin

Diagnosis

• Physical examination by a physician to feel for a bulge in the groin
• Imaging tests such as an ultrasound or CT scan may be used to confirm the diagnosis

Treatment Options

• Watchful waiting: Monitoring the hernia if it is not causing much discomfort.
• Surgical repair: The primary treatment involves surgery to repair the weakened area of the abdominal wall. Options include open hernia repair or laparoscopic surgery.
• Surgery aims to relieve symptoms and prevent complications like incarceration.

Prognosis and Follow-Up

• With appropriate surgical intervention, recurrent hernias can usually be repaired successfully.
• Regular follow-up is essential after surgery to monitor for potential recurrence or complications.

Complications

• Chronic pain
• Risk of incarceration or strangulation if untreated, although less likely without obstruction or gangrene

Lifestyle & Prevention

• Maintain a healthy weight
• Avoid heavy lifting and straining
• Engage in core-strengthening exercises to support abdominal muscles
• Quit smoking to reduce coughing and pressure on the hernia repair site

When to Seek Professional Help

• Sudden pain, nausea, vomiting, or inability to pass gas or have a bowel movement, which could signal incarceration or strangulation

Additional Resources

• American Hernia Society (www.americanherniasociety.org)
• National Institutes of Health (www.nih.gov)
• Mayo Clinic’s Inguinal Hernia Information (www.mayoclinic.org)

Tips for Medical Coders

• Ensure the code reflects the hernia's recurrent nature and absence of obstruction or gangrene (K40.91).
• Verify accurate documentation of previous surgical intervention and current symptoms.
• Avoid coding errors related to the wrong type of hernia or improper specification of laterality.