Inguinal Hernia
Inguinal hernias (these are also called inguinal hernias) occur when intestines enter the inguinal canal.An inguinal hernia is located above the inguinal ligament, in contrast to a femoral hernia, which is located below the inguinal ligament. Inguinal hernias are very common and affect preferably men (4:1). If possible, inguinal hernias are always reduced manually.
If manual reduction does not seem possible, the hernia sac is surgically reduced. In the case of frequent inguinal hernias, it may be considered to reinforce the hernial orifice interventionally with a mesh. A distinction is made between a direct (medial) and an indirect (lateral) inguinal hernia.
The hernial orifice of the direct (medial) hernia is located in the Hesselbach’s triangle, in the medial inguinal fossa (Fossa inguinalis medialis). This type of hernia is always acquired, unlike the indirect hernia. The absence of muscle at the Hesselbach’s triangle explains why direct inguinal hernias are preferred at this site: The inner abdominal wall fascia can hardly withstand alone against an increased pressure in the abdominal cavity.
After the abdominal viscera have exited, they run through the inguinal canal to the medial opening (Anulus inguinalis superficialis). In indirect (lateral) hernia, the hernial sac runs through the processus vaginalis peritonei. This can happen if the processus vaginalis does not close properly during its development – in this case it is called a congenital indirect inguinal hernia – or if it reopens – in this case the indirect inguinal hernia is acquired. In both cases, intestines enter through the lateral opening (Anulus inguinalis profundus), run in the inguinal channel and exit through the medial opening. Often the hernial sac continues to the scrotum where it causes pain and an enlargement of the scrotum.
Swelling in the inguinal channel
There are many reasons for swelling within the inguinal canal. Often the so-called inguinal hernia, also called inguinal hernia, is the cause. Compared to the muscular abdominal wall, the inguinal canal represents a natural weak point of the abdominal wall.
In an inguinal hernia, intestines push their way through the connective tissue that closes the inguinal canal to the inside, causing swelling within the inguinal canal. In the vast majority of cases, these are intestinal loops. There are several lymph nodes at the inguinal channel, which can swell for various reasons. Other reasons for a swelling in the inguinal canal would be local inflammation or the so-called hydrocele, a mostly congenital accumulation of water in the testicles, which can back up into the inguinal canal.
