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Inguinal hernias can be classified as either congenital or acquired and direct or indirect. In mature bulls all inguinal hernias are considered acquired. Indirect hernias occur when bowel passes through an intact but dilated inguinal ring. This type of herniation occurs more frequently on the left side and rarely causes strangulation of bowel. Bulls with an indirect hernia will typically present clinically normal, other than swelling in the neck of the scrotum that gives the scrotum an hourglass appearance (Figure 18.7). Direct inguinal hernias occur through the inguinal ring, but disruption or tearing of the ring or vaginal tunic is present. Direct inguinal herniation is more likely to result in strangulation and obstruction of bowel with more pronounced and generalized scrotal swelling [17, 18].

Figure 18.7 Inguinal hernia in a bull. Note characteristic swelling confined to neck of scrotum.

The presence of an inguinal hernia can be confirmed with rectal palpation and scrotal ultrasound. Palpation should reveal a dilated or disrupted inguinal ring on the affected side and the presence of herniated bowel contained in the ring. Ultrasound of the neck of the scrotum can definitively confirm the presence of bowel. Bulls with intestinal obstruction will present with abdominal pain and distention and will require emergency surgery. Inguinal hernias in bulls that present clinically normal without any signs of obstruction can be managed with elective surgery [17, 18].