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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