Get the parent to point to make sure it is above the inguinal ligament. A thickened spermatic cord can be a clue to a hernia. Check carefully that the parents are not feeling a lymph node or an undescended testis. Do not do an ultrasound or CT scan. Depends on age.
Surgery is as soon as practicable.
Surgery is usually within 6 weeks. The parents often notice a swelling when changing the nappy. The child is often irritable, not wanting to feed and if there is a prolonged, complete bowel obstruction then there is bile stained vomiting. On examination, there is a tender swelling in the groin that you cannot get above. Sometimes you can feel the testis separately below but often it is not easily felt.