Inguinal Hernia

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  • In males far more common than femoral hernias (97.5%)
  • In females twice as common as femoral
  • Can occur at any age
    • Childhood - always of developmental origin

Anatomy

Types

  • Indirect
    • Peritoneal sac passes through deep inguinal ring
    • Due to persistent processus vaginalis
    • May extend as far as upper pole of testis
  • Direct
    • Acquired
    • Weakness of posterior wall of inguinal canal (transversalis fascia)
    • Often bilateral
    • Associated with obesity, cough, constipation, prostatism

History

  • Often none (other than lump in groin)

Examination

  • superior and medial to pubic tubercle
  • soft on palpation
  • may be resonant to percussion
  • bowel sounds on auscultation
  • Test for cough impulses
  • Examine for direct/indirect
 

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