GI Radiology > Hernia > External > Inguinal

Inguinal Hernia

Inguinal hernias are the most common type of abdominal hernia. Inguinal hernias are generally classified as direct (medial to the epigastric vessels) or indirect (lateral to the epigastric vessels).

Indirect Hernias

Indirect hernias develop as a result of a patent processus vaginilis. The processus vaginilis is a remnant of the parietal peritonem that migrates with the testes from the retroperitoneum to the scrotum during the third month of gestation. During the first few months of life, the processus vaginalis is closed off in most infants, however it remains patent in 20% of children at 2 years of age. Persistance of the processus vaginalis allows bowel to migrate through the internal and external rings of the inguinal canal and into the scrotum or labia majora. Remember INdirect is INto the scrotum. Obstruction, strangulation, and incarceration can occur.

Direct Hernias

Direct hernias are the result of a direct protrusion through the floor of Hasselbach's triangle and do not pass through the internal ring. Direct hernias are much more common in men with increasing incidence with age. They are often the result of increased abdominal pressure (cough, COPD, constipation, etc.). Strangulation is unusual.

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