Small bursae may develop within or adjacent to the inguinal canal, particularly at the deep inguinal ring where the spermatic cord or round ligament exit the abdomen. Friction between the cord structures and the canal margins during walking and lifting predisposes to bursal formation.
Inguinal canal bursitis is a recognised but uncommon cause of groin pain that mimics an indirect inguinal hernia. Examination reveals a non-reducible tender swelling at the deep ring. Ultrasound with Valsalva manoeuvre differentiates a bursa (non-expanding) from a hernia (enlarges with increased intra-abdominal pressure). Aspiration is diagnostic and therapeutic.
Bursal inflammation at the deep inguinal ring producing a non-reducible groin swelling that does not expand with Valsalva, requiring ultrasound to distinguish from an early indirect inguinal hernia.
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