Inguinalhernie
An inguinal hernia is a type of groin herniation, part of a much larger group of abdominal wall hernias .
Epidemiology
They are the commonest type of abdominal wall herniation (up to 80% ) and are most often acquired. There is a recognized male predilection with an M:F ratio of up to 7:1 .
Clinical presentation
Patients most commonly present with swelling and/or pain in the relevant groin, iliac fossa, loin. Men may also have testicular pain.
Pathology
Classification
It is broadly divided into two types:
- indirect inguinal hernia
- more common
- herniates lateral to the inferior epigastric artery
- passes through the deep inguinal ring
- anterior to the spermatic cord in males
- follows the round ligament in females
- direct inguinal hernia
- less common
- a weakness in the fascial floor of the inguinal canal
- herniates medial to the inferior epigastric artery
- often through a defect in the Hesselbach triangle
Etiology
All of the following confer an increased risk for indirect inguinal hernia:
- prematurity and low birth weight
- 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
- 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.
Treatment and prognosis
Surgical treatment options include
- herniorrhaphy
- hernioplasty
Complications
Complications, as in any other abdominal wall herniation, include:
Compared with other types of abdominal wall hernias, the incidence of complications is considered lower .
Differential diagnosis
Possible imaging differential considerations include
- femoral hernia: often remain lateral to the pubic tubercle and compress the femoral vein
- hydrocele (may coexist)
- varicocele
Siehe auch:
- Schenkelhernie mit Appendix vermiformis
- Bauchwandhernien
- Skrotalhernie
- mechanischer Ileus
- Appendix in Leistenhernie
- Harnblase in Leistenhernie
- Intraperitoneale Onlay Mesh (IPOM) Hernien-Operation
- Leistenkanal
- direkte Leistenhernie
- Ligamentum inguinale
- indirekte Leistenhernie
- laparoskopische Leistenhernienoperationen
- Ovar in Leistenhernie
- Varizen des Ligamentum teres uteri
- Transabdominale präperitoneale Netzimplantation
- Total extraperitoneale Hernioplastik
- Inguinalhernie versus Schenkelhernie
- Herniographie
- Chirurgie der Leistenhernie
- Hernien der Leistenregion
- kindliche Leistenhernie
- Hesselbachdreieck
- Leistenhernie in der Schwangerschaft
- Leistenhernie der Frau