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Inguinal hernia

Last revised by Craig Hacking on 21 Feb 2024

Inguinal hernias (herniae also used) is the type of groin herniation (part of the larger group of abdominal wall hernias) that occurs above the inguinal ligament and through the inguinal canal.

Inguinal hernias are the commonest type of abdominal wall hernias (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:

A combination of ipsilateral direct and indirect inguinal herniae is a special type of pantaloon hernia and given the term Romberg hernia.

All of the following confer an increased risk for indirect inguinal hernia:

A direct inguinal hernia is a consequence of weakened abdominal musculature, often brought on by

  • advanced age

  • strain

  • 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.

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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Cases and figures

  • Case 1: probable indirect, with incarceration
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  • Case 2: on left
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  • Case 3: indirect on left
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  • Case 4: indirect in right
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  • Case 5: inguino-scrotal hernia
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  • Case 6
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  • Case 7: with perforation
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  • Case 8: bilateral direct
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  • Case 9: on the right
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  • Case 10: indirect inguinal hernia
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  • Case 11: bilateral inguinal hernia
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  • Case 12: causing small bowel obstruction
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  • Case 13: left
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  • Case 14: barium study
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  • Case 15: with large bowel obstruction
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  • Case 16: containing urinary bladder
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  • Case 17: containing urinary bladder
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  • Case 18: inguinal hernia containing sigmoid colon with sigmoid diverticulitis
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  • Case 19: causes small bowel obstruction
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  • Case 20 Obstructed indirect inguinal hernia
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