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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.
By far the most common hernias (up to 75% of all abdominal hernias) are inguinal hernias, which are further divided into the more common indirect inguinal hernia (2/3, depicted here), in which the inguinal canal is entered via a congenital weakness at its entrance (the internal inguinal ring), and the direct inguinal hernia type (1/3), where ...
Although women account for roughly 70% of femoral hernia repairs, indirect inguinal hernias are still the most common subtype of groin hernia in both males and females. [14] Inguinal hernia surgery is also one of the most common surgical procedures, with an estimated incidence of 0.8-2% and increasing up to 20% in preterm children. [15] [16]
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.
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.
In either case it would be at risk of injury during the operation to repair a femoral hernia, whether the hernia is reducible, incarcerated or strangulated. When the obturator artery travels along the lacunar ligament, it nearly encircles the femoral ring and can be lacerated during a femoral hernia repair.
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 ]
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