what is the course of a indirect inguinal hernia

Indirect inguinal hernias arise lateral and superior to the course of the inferior epigastric vessels, lateral to Hesselbach's triangle, and then protrude through the deep or internal inguinal ring into the inguinal canal. An indirect hernia enters the inguinal canal at the deep ring, lateral to the inferior epigastric vessels.

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What you should know about direct versus indirect hernias?

What You Should Know About Direct versus Indirect Hernias

• Symptoms. Both an indirect and direct inguinal hernia can cause a bulge on either side of the groin if the hernia is large enough.
• Causes. A direct hernia is usually caused when the wall of the abdominal muscles becomes weak. ...
• Risk factors. ...
• Diagnosis. ...
• Treatment. ...
• Outlook. ...
• Prevention. ...

What kind of Doctor would fix an inguinal hernia?

• Is the doctor board certified? Gastrointestinal surgeons are certified first as general surgeons by the American Board of Surgery (ABS) and other medical boards. ...
• Has the doctor been disciplined? ...
• Has the doctor published any clinical research regarding hernia repair? ...
• What do other patients say about the doctor? ...

What you should know about inguinal hernias?

• Vomiting or nausea or both
• A fever
• Intensifying pain
• A bulge/mass that becomes noticeably darker or that changes color
• Difficulty emitting flatulence or defecating

What is the treatment other than surgery for inguinal hernia?

• Genetics (a family history of hernias)
• Chronic constipation
• Overweight or obesity
• Pregnancy
• Chronic cough
• Undescended testicles
• Enlarged prostate or straining to urinate
• Birth defect (weakness in the abdominal wall)
• Aging and weakening in the abdominal wall

What is an indirect hernia?

How to treat a hernia?

What is the procedure to repair a hernia?

What is a hernia in sports?

What causes groin pain?

Where are hernias located?

How long does it take for a hernia to be strangulated?

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Why do indirect inguinal hernias occur?

Indirect inguinal hernia: An indirect inguinal hernia enters your inguinal canal through the top. This usually occurs because of a birth defect. In some babies, the opening to their canal doesn't close all the way during development in the womb.

What causes indirect hernias?

The etiology of indirect hernias is largely explainable in terms of the embryology of the groin and of testicular descent. An indirect inguinal hernia is a congenital hernia, regardless of the patient's age. It occurs because of protrusion of an abdominal viscus into an open processus vaginalis.

What is an indirect inguinal hernia?

Inguinal hernias are further subdivided into direct and indirect. An indirect hernia occurs when abdominal contents protrude through the internal inguinal ring and into the inguinal canal. This occurs lateral to the inferior epigastric vessels. The hernia contents may extend into the scrotum.

What is the main cause of inguinal hernia?

What causes inguinal hernias? A weak area in the muscles and connective tissue of the lower abdominal wall at the inguinal canal allows an inguinal hernia to develop. A hernia can form in different ways, causing two types of hernias.

How do you fix a indirect inguinal hernia?

Indirect inguinal hernias are caused by a persistent opening that does not close during fetal development. The only way to repair an inguinal hernia is through surgery.

Can indirect inguinal hernia be acquired?

In other word, the presence of the thickening means that fusion of the processus vaginalis has previously taken place. Thus, most indirect inguinal hernias in adults may represent acquired diseases.

Which is worse direct or indirect hernia?

An indirect hernia may also cause bowel obstruction if it slips into the inguinal ring and becomes swollen in the abdomen. This condition can worsen into a phase known as “strangulation,” which can affect blood flow in the intestines. A direct hernia is less likely to cause strangulation of the bowel.

Why is an indirect inguinal hernia more common in male patients?

Indirect inguinal hernia. Although it can occur in men and women, it is much more common in men. This is because the male testicle starts inside the abdomen and has to go down through an opening in the groin area to reach the scrotum (the sac that holds the testicles).

What happens if inguinal hernia left untreated?

If hernia is left untreated, the size of protruding intestine might get bigger and become strangulated leading to the reduction of blood flow to surrounding tissue.

What are the risk factors of inguinal hernia?

Risk factors for developing a primary inguinal hernia are male gender and old age (9, 10), a patent processus vaginalis (7), systemic connective tissue disorders (13, 14), and a low body mass index (BMI) (10, 15). Increasing age and low BMI increase the risk of both medial and lateral hernia repairs (12).

How can you prevent a hernia from getting worse?

If you have a hernia, try to keep it from getting worse:Avoid heavy lifting when you can. Lifting puts stress on the groin.When you must lift, don't bend over. Lift objects by using the legs, not the back.Eat high-fiber foods and drink plenty of water. ... Maintain a healthy body weight.

Direct vs. Indirect Hernia: Key Differences and Causes

Open surgery: Your doctor will make an incision in your abdomen to locate and repair the hernia.The surgeon may use stitches and a piece of mesh for extra support when closing the abdominal wall. Laparoscopic surgery: This is done by making several tiny holes in the abdomen. Your doctor will then insert special tools that will allow the surgeon to see the hernia and repair it.

What is an indirect hernia?

Indirect hernias are located near the groin and occur when abdominal contents, such as the intestines, pass through an opening into a channel called the inguinal canal.

How to treat a hernia?

Treatment may first involve clinical observation for a period of time followed by surgery in order to fully resolve the hernia. A physician is needed to determine the course of treatment. A hernia reduction will be attempted, meaning that the bulging loop of intestine will be carefully pushed back, if possible.

What is the procedure to repair a hernia?

Laparoscopic surgery: This involves small incisions in the abdomen or groin area. A small camera, as well as surgical instruments, are passed through the incisions to repair the hernia. The surgeon may place a piece of mesh over the opening of the hernia to prevent it from reforming.

What is a hernia in sports?

A sports hernia is a painful, soft tissue injury that occurs in the groin area and occurs during sports that require sudden changes of direction or intense twisting movements.

What causes groin pain?

Pain in the groin can occur in athletes from muscle strains or tears in the tendon. Nerve damage and compression can also cause groin pain.

Where are hernias located?

Hernias occur when an organ protrudes through part of the abdominal / pelvic wall that normally contains it. Indirect hernias are located near the groin and occur when abdominal contents, such as the intestines, pass through an opening into a channel called the inguinal canal. Symptoms include a bulge in the groin that may become more prominent ...

How long does it take for a hernia to be strangulated?

People with indirect hernias that become strangulated need to undergo emergency surgery within four to six hours to prevent permanent damage to the bowel (bowel infarction) that is trapped within the hernia. There are a number of surgical options for treating indirect hernias:

What is indirect inguinal hernia?

Indirect inguinal hernia. Indirect inguinal hernias (alternative plural: herniae), a type of groin herniation , are the most common type of abdominal hernia.

Where do indirect hernias protrude?

Indirect inguinal hernias arise lateral and superior to the course of the inferior epigastric vessels, lateral to Hesselbach's triangle, and then protrude through the deep or internal inguinal ring into the inguinal canal. An indirect hernia enters the inguinal canal at the deep ring, lateral to the inferior epigastric vessels.

How common is an inguinal hernia?

It is five times more common than a direct inguinal hernia , and is seven times more frequent in males, due to the persistence of the processus vaginalis during testicular descent. In children, the vast majority of inguinal hernias are indirect.

What are the complications of an inguinal hernia?

Complications include: incarceration. the most common complication associated with inguinal hernias, the incidence could be as high as 30% for infants younger than 2 months. strangulation with bowel ischemia and perforation. intestinal obstruction.

Is spermatic cord lipoma an indirect hernia?

On testicular ultrasound, one could consider spermatic cord lipoma on the differential if an inguinal hernia contains only omental fat. Movement of the fat with the Valsalva maneu ver is more likely an indirect hernia.

What to do if you suspect an inguinal hernia?

If you suspect you or your child has an inguinal hernia, you should seek medical attention. If it is not treated, an inguinal hernia can develop into a serious condition.

How many types of inguinal hernias are there?

There are 2 types of inguinal hernias:

How do you repair an inguinal hernia?

There are 3 types of inguinal hernia repair: Open hernia repair: A surgical procedure in which an incision, or cut, is made in the groin. The surgeon then pushes the hernia back into the abdomen and strengthens the abdominal wall with mesh and stitches.

What is the term for a bulging muscle in the abdomen?

A hernia is a common condition in which part of an internal organ or tissue bulges through a muscle. An inguinal hernia occurs when the intestines or fat from the abdomen bulge through the lower abdominal wall into the inguinal, or groin, area. Symptoms and treatments are described in this article. Appointments & Access.

Why are inguinal hernias more common in later life?

Hernias can be on one or both sides of the abdomen. Direct inguinal hernias are more common later in life because the abdominal wall weakens with age.

What is robotic hernia repair?

Robotic hernia repair: Like laparoscopic surgery, robotic surgery uses a laparoscope, and is performed in the same manner (small incisions, a tiny camera and projecting the inside of the abdomen onto television screens).

What is the best way to check for a hernia?

An abdominal X-ray or CT scan may be ordered to look for a hernia and determine if it is strangulated or incarcerated.

What is the most common type of inguinal hernia?

Indirect hernias are the most common type of inguinal hernia. Although they occur in both sexes, they are more more common in males than females.

How many types of inguinal hernias are there?

There are two types of inguinal hernias:

How often should you have an inguinal hernia surgery?

undergoing the operation every year. Surgery does not always have to be immediate, but if an inguinal hernia is discovered, it must be monitored closely by a doctor to see if the symptoms get worse. If the tissue of the hernia becomes trapped or incarcerated, then surgery will be more urgent.

How common is a hernia in men?

Most common in children, it affects up to 5 percent of newborns and up to 30 percent of premature babies. Often, it is discovered in the first year of life but can remain undetected until adulthood. Inguinal hernias are up to 10 times more more common in men than women and one in four men will develop a hernia at some point in their life.

What happens when the inguinal canal fails to close?

When the inguinal canal opening fails to close completely by the time of birth, this allows a portion of fat or intestine to slip through and cause an indirect hernia.

How many premature babies have an indirect hernia?

Indirect hernia. Share on Pinterest. Indirect hernias affect up to 30 percent of premature babies. While a fetus is still in the womb, there is an internal opening to the inguinal canal, but this usually closes before birth.

Why does my inguinal canal hurt?

Aging and stress or strain can weaken the muscles around the inguinal canal. Previous surgery in the lower abdomen can also weaken the muscles there. It is much less common for females to develop a direct hernia.

What is an indirect inguinal hernia?

They are more common in babies with testicles. 3 These hernias occur when one or both of the inguinal canals do not close during fetal development. 1

How do inguinal hernias differ from indirect hernias?

Direct hernias protrude through the posterior (back) wall of the inguinal canal. Indirect hernias protrude through the inguinal ring.

How are indirect and direct hernias similar?

Indirect and direct inguinal hernias are similar in that they both present as bulges in the groin area. They also are both caused by organs pushing through the inguinal canal. However, indirect and direct hernias occur in different locations.

Why are inguinal hernias more common in testicles?

Direct inguinal hernias are also more common in people with testicles. That's because they have a wider inguinal canal than those with ovaries. As a result, over time, the canal is more likely to stretch out and become weak.

How common are inguinal hernias?

Inguinal hernias are quite common. In fact, 27% of people with testicles and 3% of people with ovaries will develop an in guinal hernia in their lifetime. 1

What causes a bulge in the groin area?

When that happens, part of the internal abdominal organs pushes through that canal, causing a bulge in the groin area.

Where do hernias protrude?

Direct hernias protrude through the back wall of the inguinal canal, while indirect hernias protrude through the inguinal ring.

An inguinal hernia happens when part of your intestines or intestinal fat pushes through a weak area of muscle and forms a lump outside your abdomen. Direct and indirect inguinal hernias occur differently, but the symptoms and the treatment are the same

Inguinal hernias occur in about 25% of men. It may begin as a painless bulge, but it must be treated before it becomes strangulated.

Who Is Affected by Inguinal Hernias?

Inguinal hernias are common. They occur in about 25 percent of men. They are less common in women, but inguinal hernias in women are possible. Only between 2 to 3 percent of women will get an inguinal hernia. In babies and children, indirect inguinal hernias are common up to age five.

Inguinal Hernia Symptoms

Indirect and direct inguinal hernias have the same signs and symptoms. They include:

Inguinal Hernia Repair

The only treatment for an inguinal hernia is surgery. If you have an inguinal hernia that comes and goes and does not cause any symptoms, you may be able to delay surgery for a while, called watchful waiting. However, inguinal hernias do not heal by themselves.

When does an indirect hernia occur?

An indirect hernia usually first occurs in infancy. That’s because it’s often a congenital condition. An indirect hernia in an infant may be most noticeable when the baby is crying. A direct hernia almost always develops in adulthood, usually later in life, unless the problem is the result of a specific injury.

How to reduce the risk of a hernia?

Lose weight if you’re overweight or obese. Weight loss won’t eliminate your risk of a hernia, but it will ease the strain on your abdominal muscles.

What is the most common type of hernia?

Inguinal hernias are the most common type of hernia. They form when there’s a thin spot on your abdominal wall.

What is the procedure called when a hernia is removed?

Laparoscopic surgery is a growing option for many types of abdominal surgeries, including hernia operations. A doctor uses special instruments that can be inserted through a few small incisions. One of the instruments is a tiny camera that allows the surgeon to see the hernia and treat it.

How is a hernia repaired?

In adults, open surgery is often done to repair a direct hernia. A large incision is made and the hernia is moved back into place. The abdominal wall is repaired, sometimes with a small mesh device that provides added strength to the affected wall.

How long does it take to recover from a hernia surgery?

Surgeries to repair hernias are common and have high success rates, so you should expect a full recovery. It may be several weeks before you’re back doing all your usual activities.

Is a hernia on one side of the groin a direct hernia?

That means a hernia that forms one side of the groin or the other is most likely a direct hernia. An indirect hernia may also cause bowel obstruction if it slips into the inguinal ring and becomes swollen in the abdomen.

How can a hernia be reduced?

Hernia can be reduced by medial pressure applied first.

Is an indirect inguinal hernia a congenital hernia?

The etiology of indirect hernias is largely explainable in terms of the embryology of the groin and of testicular descent. An indirect inguinal hernia is a congenital hernia, regardless of the patient’s age. It occurs because of protrusion of an abdominal viscus into an open processus vaginalis. The following terms are employed:

What is an indirect hernia?

This is the congenital type of the sac. With incomplete descent of the testis ( undescended testis) there is usually an associated indirect hernial sac. Undescended testis is a common condition of infancy. It requires surgery to place the testis in the correct position. It may not be diagnosed early and this can cause problems. The testis in infancy, childhood and adolscence may undergo torsion ( another surgical emergency).

Where do indirect hernias protrude?

There are two basic types, but they both protrude through the superficial external ring of the inguinal canal in the groin. The INDIRECT descends along the spermatic cord in males from the deep internal ring. Or the round ligament in females. The indirect occur at any age, from infancy to the elderly. In children or females the hernia is invariably ...

What is the patent process vaginalis?

Persistence of a patent process vaginalis is also responsible for communicating hydroceles of the testis and encysted hydrococeles of the cord. There is conjecture as to whether this congenital type of sac (persistent patent process vaginalis) is responsible for the development of indirect herniae in adults or whether the herniae developed as a new event, associated with failure of the muscular shutter mechanism at the internal ring. The ‘congenital sac’ theory assumes there is a congenital sac which only fills with contents in adult life. It is not always possible to distinguish clinically between a direct and indirect inguinal hernia.

Why should indirect hernias be surgically repaired?

Generally indirect herniae should be surgically repaired because they become larger, cause symptoms and may obstruct and strangulate.

How common are inguinal hernias?

Inguinal hernias are the most common type encountered in surgical practice (approx. 80%). They are far more common in men than women. They occur at any age – from the newborn to the elderly.

What is an undescended testis?

Undescended testis is a common condition of infancy. It requires surgery to place the testis in the correct position. It may not be diagnosed early and this can cause problems. The testis in infancy, childhood and adolscence may undergo torsion ( another surgical emergency).

Why do you need a truss for a hernia?

A truss is sometimes used to prevent the hernia protruding and to minimise the discomfort. A truss is often used when the patient declines or is considered unfit for surgery.

What is an indirect hernia?

Indirect hernias are located near the groin and occur when abdominal contents, such as the intestines, pass through an opening into a channel called the inguinal canal.

How to treat a hernia?

Treatment may first involve clinical observation for a period of time followed by surgery in order to fully resolve the hernia. A physician is needed to determine the course of treatment. A hernia reduction will be attempted, meaning that the bulging loop of intestine will be carefully pushed back, if possible.

What is the procedure to repair a hernia?

Laparoscopic surgery: This involves small incisions in the abdomen or groin area. A small camera, as well as surgical instruments, are passed through the incisions to repair the hernia. The surgeon may place a piece of mesh over the opening of the hernia to prevent it from reforming.

What is a hernia in sports?

A sports hernia is a painful, soft tissue injury that occurs in the groin area and occurs during sports that require sudden changes of direction or intense twisting movements.

What causes groin pain?

Pain in the groin can occur in athletes from muscle strains or tears in the tendon. Nerve damage and compression can also cause groin pain.

Where are hernias located?

Hernias occur when an organ protrudes through part of the abdominal / pelvic wall that normally contains it. Indirect hernias are located near the groin and occur when abdominal contents, such as the intestines, pass through an opening into a channel called the inguinal canal. Symptoms include a bulge in the groin that may become more prominent ...

How long does it take for a hernia to be strangulated?

People with indirect hernias that become strangulated need to undergo emergency surgery within four to six hours to prevent permanent damage to the bowel (bowel infarction) that is trapped within the hernia. There are a number of surgical options for treating indirect hernias:

Epidemiology

Pathology

• Indirect inguinal hernias arise lateral and superior to the course of the inferior epigastric vessels, lateral to Hesselbach's triangle, and then protrude through the deep or internal inguinal ring into the inguinal canal. An indirect hernia enters the inguinal canalat the deep ring, lateral to the inferior epigastric vessels. It passes inferomedia...

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Treatment and Prognosis

Differential Diagnosis