Incarceration is the inability to reduce hernia sac contents into the abdominal cavity. Hernias containing intestines generally occur in boys, especially with a history of prematurity, and are caused by failure of the process vaginalis to fuse after testicular descent. In girls, hernia most often includes the ovary. Patients most often present with a history of an inguinal or scrotal bulge that becomes more prominent with increased abdominal pressure (crying, straining, coughing, laughing). Other symptoms include inguinal swelling alone or in conjunction with pain and vomiting (may become bilious from intestinal obstruction or strangulation), irritability, poor feeding, lack of bowel movements, and abdominal distension. Incarceration is more common in patients <2 years old. Clinical characteristics include a firm, immobile, and often tender and erythematous swelling. When the hernia is in the scrotum, the bowel is palpable distinct of the testicle.