Nyhus Classification

Question 1

Indirect hernia; internal abdominal ring normal; typically in infants, children, small adults

Answer 1

Type I

Question 2

Indirect hernia; internal ring enlarged without impingement on the floor of the inguinal canal; does not extend to the scrotum

Answer 2

Type II

Question 3

Direct hernia; size is not taken into account

Answer 3

Type IIIA

Question 4

Indirect hernia that has enlarged enough to encroach upon the posterior inguinal wall; indirect sliding or scrotal hernias are usually placed in this category because they are commonly associated with extension to the direct space; also includes pantaloon hernias

Answer 4

Type IIIB

Question 5

Femoral hernia

Answer 5

Type IIIC

Question 6

Recurrent hernia; modifiers A–D are sometimes added, which correspond to indirect, direct, femoral, and mixed, respectively

Answer 6

Type IV