The diagnostic findings of history, physical examination, rectal examination, barium enema, and sigmoidoscopy in 684 patients with the initial complaint of inguinal hernia were examined. History and physical examination led to the diagnosis of four cancers of the colon and one villous adenoma. No significant new findings were made by sigmoidoscopy when symptoms elicited by history did not indicate some abnormality. A cost analysis of finding significant disease in these patients with inguinal hernias indicates that in-hospital evaluation by barium enema and sigmoidoscopy is probably not warranted.
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