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Direct inguinal hernia

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Direct inguinal hernia

Inguinal hernia
Classification and external resources
ICD-10 9 DiseasesDB MedlinePlus eMedicine MeSH C06.405.293.249.437

The direct inguinal hernia, a type of inguinal hernia, enters through a weak point in the fascia of the abdominal wall, and its sac is noted to be medial to the inferior epigastric vessels. Direct inguinal hernias may occur in males or females, but males are ten times more likely to get a direct inguinal hernia.[1]

Anatomy

A direct inguinal hernia protrudes through a weakened area in the transversalis fascia near the medial inguinal fossa within an anatomic region known as the inguinal or Hesselbach's triangle, an area defined by the edge of the rectus abdominis muscle, the inguinal ligament and the inferior epigastric artery. These hernias are capable of exiting via the superficial inguinal ring but, unlike indirect inguinal hernias, they cannot move into the scrotum.

When a patient suffers a simultaneous direct and indirect hernia on the same side, the result is called a "pantaloon" hernia (because it looks like a pair of pants, with the epigastric vessels in the crotch), and the defects can be repaired separately or together.

Risk Factors

Since the abdominal walls weaken with age, direct hernias tend to occur in the middle-aged and elderly. This is in contrast to indirect hernias which, although their etiology includes a congenital component, can occur at any age [2][3] Additional risk factors include chronic constipation, overweight/obesity, chronic cough, family history and prior episodes of direct inguinal hernias.[4]

References

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