Referral Patterns and Outcomes Following Incidental Computed Tomography Reporting of Fat-Containing Inguinal Hernias.

INTRODUCTION: Inguinal hernia repair is common, with most diagnoses made clinically. However, incidental "inguinal hernia" findings on computed tomography (CT) scans performed for unrelated reasons may prompt surgical referral. This study evaluated referral patterns and surgical outcomes following incidental CT diagnoses in radiology reports. METHODS: We performed a retrospective review (2015-2025) of patients at our institution with "fat-containing inguinal hernia" reported on CT abdomen/pelvis obtained for nonhernia indications. We assessed referral rates, clinical findings, and surgical outcomes. RESULTS: Among 1145 patients, 47 (4.1%) were referred to for surgical evaluation. Of these patients, 19 (40.4%) had a hernia on exam, and 17 (36.2%) were recommended for repair. Ultimately, 12 patients (1% overall; 25.5% of referrals) underwent surgery. CONCLUSIONS: Most incidental CT report wording of inguinal hernias do not lead to referral or surgery and clinical correlation is important. Primary care evaluations may help identify patients who warrant surgical consultation while reducing unnecessary referrals.