They are the commonest type of abdominal wall herniation (up to 80% 3) and are most often acquired. There is a recognized male predilection with an M:F ratio of up to 7:1 3.
Patients most commonly present with swelling and/or pain in the relevant groin, iliac fossa, loin. Men may also have testicular pain.
It is broadly divided into two types:
- indirect inguinal hernia (more common)
- direct inguinal hernia (less common)
All of the following confer an increased risk for indirect inguinal hernia:
- prematurity and low birth weight 9
- patent processus vaginalis
- urologic conditions (e.g. cryptorchidism, hypospadias or epispadias, bladder exstrophy, ambiguous genitalia)
- abdominal wall defects (omphalocele, gastroschisis, cloacal exstrophy, bladder exstrophy)
- family history
A direct inguinal hernia is a consequence of weakened abdominal musculature, often brought on by
- advanced age
- previous abdominal surgery
While inguinal hernias, in general, are much more common in males than in females, direct hernias, in particular, are rare in women since the broad ligament acts as an additional barrier.
Treatment and prognosis
Surgical treatment options include
Complications, as in any other abdominal wall herniation, include:
Compared with other types of abdominal wall hernias, the incidence of complications is considered lower 3.
Possible imaging differential considerations include
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