Inguinal Hernia
A groin-wall defect allows fat or bowel to protrude through the inguinal canal; the key clinical decisions are whether it is reducible, whether it is symptomatic, and whether obstruction or strangulation makes it an emergency.
Definition
An inguinal hernia is protrusion of abdominal contents through a defect or weakness in the groin, commonly along or adjacent to the inguinal canal. It may be reducible, chronically irreducible, acutely irreducible or complicated by bowel obstruction and strangulation.
First principles
A hernia is a defect, not a mass that medicines can cure
An inguinal hernia is protrusion of fat, peritoneal sac or bowel through a weakness in the groin, often becoming more visible with standing, coughing or straining and less visible when lying down. The inguinal canal is a natural area of weakness containing the spermatic cord in men or the round ligament in women. Indirect hernias pass through the deep ring; direct hernias push through the posterior wall medial to the inferior epigastric vessels. The direct-versus-indirect distinction usually matters less than the clinical state and operative plan.
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