Imaging Abdominal Wall and Groin Hernias: Patterns, Diagnosis, and Complications

Abstract Abdominal wall hernias are common imaging findings that may range from an incidental discovery to a clinically significant condition requiring urgent surgical intervention. While most hernias are asymptomatic, some may progress to serious complications such as bowel obstruction or strangulation, or less commonly entrapment of other intra-abdominal structures. The risk of complications varies by hernia type, with certain subtypes such as femoral, obturator, Spigelian, and sciatic hernias carrying a higher risk for complications. Since many hernias are clinically occult and difficult to detect on physical examination, radiologists play a critical role in their initial identification. This article reviews the key anatomic landmarks and imaging features of both common and rare abdominal wall and groin hernias, while also addressing their epidemiology, complications, and management strategies. Emphasis is placed on the radiologist's role in recognizing subtle imaging findings and distinguishing hernia subtypes, which is essential for timely diagnosis and appropriate triage of patients who may require urgent surgical intervention.