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A man is moving into a new house and during the process lifts a large chest of drawers. As he lifts he feels a severe pain in the lower right quadrant of his abdomen. He finds that he can no longer lift without pain and the next day goes to see his physician. Surgery is indicated and during the surgery the surgeon opens the inguinal region and finds a hernial sac with a small knuckle of intestine projecting through the abdominal wall just above the inguinal ligament and lateral to the inferior epigastric vessels. The hernia was diagnosed as:
A-CONGENITAL INGUINAL HERNIA
B-A DIRECT INGUINAL HERNIA
C-A FEMORAL HERNIA
D-AN INCISIONAL HERNIA
E-AN INDIRECT INGUINAL HERNIA
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An indirect inguinal hernia
An indirect inguinal hernia leaves the abdominal cavity lateral to the inferior epigastric vessels and enters the inguinal canal through the deep inguinal ring. Commonly, these hernias traverse the entire inguinal canal, leave the canal through the superficial inguinal ring, and enter the scrotum. The indirect inguinal hernias are the most common type of hernia, and are often caused by heavy lifting. Direct inguinal hernias leave the abdominal cavity medial to the inferior epigastric vessels, through the weak fascia. These usually do not traverse the entire inguinal canal, and they rarely enter the scrotum. Direct inguinal hernias may be caused by a weakness of abdominal musculature.
Congenital inguinal hernias are indirect hernias that occur due to the persistance of the processus vaginalis, an embryonic structure that is a diverticulum of the peritoneal cavity extending into the labial or scrotal folds. A femoral hernia is caused by abdominal viscera pushing through the femoral ring into the femoral canal. An incisional hernia occurs after surgery, when omentum or an organ protrudes through a surgical incision due to poor healing.
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E. IIH:
passes through the deep inguinal ring.inguinal canal, and superficial inguinal ring and descends into the scrotum. The hernia lies LATERAL to the in.f epig. vessels
