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

• inguinal canal

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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