Inguinal Hernias (table B2.1)

Question 1

What is another name for a direct hernia?

Answer 1

Aquired Hernia

Question 2

What is another name for a indirect hernia?

Answer 2

Congenital Hernia

Question 3

What are the predisposing factors for a direct (acquired) hernia?

Answer 3

Weakness of anterior abdominal wall in inguinal triangle

e.g. owing to distended superficial ring, narrow inguinal falx, or attenuation of aponeurosis in males > 40 y/o

Question 4

What are the predisposing factors for a indirect (congenital) hernia?

Answer 4

Patency of processus vaginalis (complete or at least superior part) in younger persons, the great majority of which are males

Question 5

What is the frequency of the direct hernia?

Answer 5

Less common (1/3 to 1/4 of inguinal hernias)

Question 6

What is the frequency of the indirect hernia?

Answer 6

More common (2/3 to 3/4 of inguinal hernias)

Question 7

What is the exit from the abdominal cavity for a direct hernia?

Answer 7

Peritoneum plus transversalis fascia (lies outside inner one or two fascial coverings of cord)

Question 8

What is the exit from the abdominal cavity for an indirect hernia?

Answer 8

Peritoneum of persistent processus vaginalis plus all three fascial coverings of cord/round ligament

Question 9

What is the course for a direct hernia?

Answer 9

Passes through or around inguinal canal, usually traversing only medial third of canal, external and parallel to vestige of processus vaginalis

Question 10

What is the course for an indirect hernia?

Answer 10

Traverses inguinal canal (entire canal if it is of sufficient size) within processus vaginalis

Question 11

What is the exit from the anterior abdominal wall for a direct hernia?

Answer 11

Via superficial ring, lateral to cord

Rarely enters scrotum

Question 12

What is the exit from the anterior abdominal wall for an indirect hernia?

Answer 12

Via superficial ring inside cord

Commonly passes into scrotum/labium majus