Inguinal hernia

Inguinal hernia

eMedicine2|ped|2559
MeshName = Hernia,+Inguinal
MeshNumber = C06.405.293.249.437

Inguinal hernias (IPAEng|ɪnˈgwinəl ˈhɝniəz) are protrusions of abdominal cavity contents through the inguinal canal. They are very common (it is estimated that 5% of the population will develop an abdominal wall hernia)Fact|date=January 2008 and their repair is one of the most frequently performed surgical operations.

There are two types of inguinal hernia, "direct" and "indirect". Direct inguinal hernias occur when abdominal contents herniate through a weak point in the fascia of the abdominal wall and into the inguinal canal. Indirect inguinal hernias occur when abdominal contents protrude through the deep inguinal ring; this is ultimately caused by failure of embryonic closure of the processus vaginalis.

Origin

In men, indirect hernias follow the same route as the descending testes, which migrates from the abdomen into the scrotum during the development of the urinary and reproductive organs. The larger size of their inguinal canal, which transmitted the testicle and accommodates the structures of the spermatic cord, might be one reason why men are 25 times more likely to have an inguinal hernia than women. Although several mechanisms such as strength of the posterior wall of the inguinal canal and shutter mechanisms compensating for raised intra-abdominal pressure prevent hernia formation in normal individuals, the exact importance of each factor is still under debate.cite journal |author=Desarda MP |title=Surgical physiology of inguinal hernia repair--a study of 200 cases |journal=BMC Surg |volume=3 |issue= |pages=2 |year=2003 |pmid=12697071 |pmc=155644 |doi= |url=http://www.biomedcentral.com/1471-2482/3/2]

Clinical presentation

Hernias present as bulges in the groin area that can become more prominent when coughing, straining, or standing up. They are often painful, and the bulge commonly disappears on lying down. The inability to "reduce", or place the bulge back into the abdomen usually means the hernia is "incarcerated," often necessitating emergency surgery.

As the hernia progresses, contents of the abdominal cavity, such as the intestines, can descend into the hernia and run the risk of being pinched within the hernia, causing an intestinal obstruction. If the blood supply of the portion of the intestine caught in the hernia is compromised, the hernia is deemed "strangulated," and gut ischemia and gangrene can result, with potentially fatal consequences. The timing of complications is not predictable; some hernias remain static for years, others progress rapidly from the time of onset. Provided there are no serious co-existing medical problems, patients are advised to get the hernia repaired surgically at the earliest convenience after a diagnosis is made. Emergency surgery for complications such as incarceration and strangulation carry much higher risk than planned, "elective" procedures.

Diagnosis

The diagnosis of inguinal hernia rests on the history given by the patient and the physician's examination of the groin. Further tests are rarely needed to confirm the diagnosis. However, in unclear cases an ultrasound scan or a CT scan might be of help, especially to rule out a hydrocele.

urgical treatment

:"See main article at herniorrhaphy."Surgical correction of inguinal hernias, called a herniorrhaphy or hernioplasty, is now often performed as an ambulatory, or "day surgery," procedure. There are various surgical strategies which may be considered in the planning of inguinal hernia repair. These include the consideration of mesh use, type of open repair, use of laparoscopy, type of anesthesia, appropriateness of bilateral repair, etc. During surgery conducted under local anaesthesia, the patient will be asked to cough and strain during the procedure to help in demonstrating that the repair is "tension free" and sound. [ [http://www.paralumun.com/inguinal.htm Inguinal Hernia ] ]

ubtypes of inguinal hernias

Inguinal hernias, in turn, belongs to groin hernias, which also includes femoral hernias. A femoral hernia is not via the inguinal canal, but via the femoral canal, which normally allows passage of the common femoral artery and vein from the pelvis to the leg.

In Amyand's hernia, the content of the inguinal hernia is the appendix.


=Additional

References


=External

* [http://www.biomedcentral.com/1471-2482/3/2 Posterior wall of the inguinal canal at rest, Figure 3]
* [http://www.biomedcentral.com/1471-2482/3/2 Posterior wall of the inguinal canal during raised intra-abdominal pressure, Figure 4]

Web Resources

[http://www.herniasymptoms.org/inguinal-hernias.html Inguinal Hernia Resources]


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Look at other dictionaries:

  • inguinal hernia — n a hernia in which part of the intestine protrudes into the inguinal canal * * * see hernia * * * herniation of a loop of intestine into the inguinal canal. See direct inguinal h. and indirect inguinal h., and see accompanying table. Called also …   Medical dictionary

  • inguinal hernia — noun hernia in which a loop of intestine enters the inguinal canal; the most common type of hernia in males • Hypernyms: ↑hernia, ↑herniation * * * Pathol. a common type of hernia in which a loop of the intestine protrudes directly through a weak …   Useful english dictionary

  • inguinal hernia — Pathol. a common type of hernia in which a loop of the intestine protrudes directly through a weak area of the abdominal wall in the groin region. * * * …   Universalium

  • inguinal hernia — see hernia …   The new mediacal dictionary

  • Direct inguinal hernia — Inguinal hernia Classification and external resources ICD 10 K40 ICD 9 550 …   Wikipedia

  • Indirect inguinal hernia — eMedicine2|ped|2559 MeshID = D006552 An indirect inguinal hernia is an inguinal hernia which results from the failure of embryonic closure of the internal inguinal ring after the testicle has passed through it. Like other inguinal hernias, it… …   Wikipedia

  • Hernia — Classification and external resources Frontal chest X ray showing a hernia of Morgagni ICD 10 K …   Wikipedia

  • Hernia inguinal — con protrusión de vísceras intestinales. Clasificación y recursos externos CIE 10 K40 …   Wikipedia Español

  • hernia inguinal — f. anat. patol. Hernia que se localiza en el pliegue de la ingle asociada a un debilitamiento de los músculos de la pared abdominal. Es una hernia muy habitual y afecta, principalmente, a los hombres. Medical Dictionary. 2011 …   Diccionario médico

  • Inguinal — In gui*nal, a. [L. inguinalis, fr. inguen, inguinis, the groin: cf. F. inguinal.] (Astron. & Med.) Of or pertaining to, or in the region of, the inguen or groin; as, an inguinal canal or ligament; inguinal hernia. [1913 Webster] {Inguinal ring}.… …   The Collaborative International Dictionary of English

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