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An inguinal hernia or groin hernia is a hernia (protrusion) of abdominal cavity contents through the inguinal canal. Symptoms, which may include pain or discomfort especially with or following coughing, exercise, or bowel movements , are absent in about a third of patients.
Groin hernias account for almost 75% of all abdominal wall hernias with the lifetime risk of an inguinal hernia in men and women being 27% and 3% respectively. Men account for nearly 90% of all repairs performed and have a bimodal incidence of inguinal hernias peaking at 1 year of age and again in those over the age of 40.
An indirect inguinal hernia and a direct inguinal hernia can be distinguished by their positioning in relation to the inferior epigastric vessels. An indirect hernia is situated laterally to these vessels, whereas a direct hernia is positioned medially to them. Inguinal hernias are the most common type of hernia in both men and women.
It is more often seen in men, and predominantly on the right side. Maydl's hernia should be suspected in patients with large incarcerated herniae and in patients with evidence of intra-abdominal strangulation or peritonitis. Postural or manual reduction of the hernia is contra-indicated as it may result in non-viable bowel being missed. [2]
Amyand's hernia is a rare form of an inguinal hernia (less than 1% of inguinal hernias) [2] which occurs when the appendix is included in the hernial sac and becomes incarcerated. The condition is an eponymous disease named after a French surgeon , Claudius Amyand (1660–1740), [ 3 ] who performed the first successful appendectomy in 1735.
Internal hernias occur when there is protrusion of an internal organ into a retroperitoneal fossa or a foramen (congenital or acquired) in the abdominal cavity. If a loop of bowel passes through the mesenteric defect, that loop is at risk for incarceration , strangulation , or for becoming the lead point of a small bowel obstruction . [ 1 ]
Post herniorrhaphy pain syndrome, or inguinodynia is pain or discomfort lasting greater than 3 months after surgery of inguinal hernia. Randomized trials of laparoscopic vs open inguinal hernia repair have demonstrated similar recurrence rates with the use of mesh and have identified that chronic groin pain (>10%) surpasses recurrence (<2%) and is an important measure of success.
Left and right inguinal regions shown in lower part of diagram. In human anatomy, the groin, also known as the inguinal region or iliac region, [1] is the junctional area between the torso and the thigh. [2] The groin is at the front of the body on either side of the pubic tubercle, where the lower part of the abdominal wall meets the thigh.
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