Indirect hernia. When the inguinal canal opening fails to close completely by the time of birth, this allows a portion of fat or intestine to slip through and cause an indirect hernia. In females, the ovaries and other parts of the reproductive system can slide through the opening and cause a hernia.
Full Answer
What causes an indirect inguinal abdominal hernia?
- Abnormal development: In normal development, the opening to the inguinal canal near the inside of the abdomen closes off, preventing abdominal contents from entering the inguinal canal. ...
- Chronic coughing or constipation: This can cause an indirect hernia due to increasing the pressure within the abdomen.
- Injury to the abdomen
- Smoking
What are the signs of an inguinal hernia?
- A bulge in your groin area: If so, you may have a direct or indirect hernia.
- You will see swelling in the lower part of your abdomen that extends down toward or even into your scrotum.
- A bulge on the thigh below your groin: This is most likely a femoral hernia.
Is inguinal hernia direct or indirect?
Inguinal hernias may be direct or indirect. The difference is in the anatomical location. Direct hernias protrude through the posterior (back) wall of the inguinal canal. Indirect hernias protrude through the inguinal ring. Indirect hernias are often congenital, whereas direct hernias are due to heavy lifting or straining. 2
What to do about an inguinal hernia?
Part 1 Part 1 of 3: Treating Hernia Pain at Home
- Use ice packs. If you're feeling relatively mild discomfort, apply an ice pack to the site of your hernia for 10 to 15 minutes.
- Take medication to manage pain. If you're experiencing moderate hernia pain, you may get some relief from over-the-counter (OTC) pain relievers like ibuprofen and acetaminophen.
- Take medication to treat reflux. ...
What causes an indirect hernia?
This type of hernia occurs in adults over time, from a combination of weakening abdominal muscles and chronic pressure on the muscle wall. Indirect inguinal hernia: An indirect inguinal hernia enters your inguinal canal through the top. This usually occurs because of a birth defect.
What are indirect hernias?
An indirect hernia is not caused by weakened or injured abdominal muscles. Instead, it occurs when an area of abdominal muscle tissue called the inguinal ring fails to close up while a baby is in the mother's womb. In boys, the ring allows the testicles to drop into the scrotum, and then usually closes.
Do indirect hernias need surgery?
If it is an indirect inguinal hernia and you are having pain, you should probably have surgery. Since the indirect inguinal hernia is an actual “defect” or a hole within the strong fascial layer with abdominal or pelvic content pushing through the defect, it will not heal without surgery.
What is difference between direct and indirect hernia?
There are two types of inguinal hernias: Direct: Develops over time due to straining and is caused by weakness in the abdominal muscles. Most common in adult males and rare in children. Indirect: Caused by a defect in the abdominal wall that will typically have been present since birth.
How do you fix an indirect hernia?
open surgery – where a cut is made to allow the surgeon to push the lump back into the abdomen. laparoscopic (keyhole) surgery – a less invasive, but more difficult, technique where several smaller cuts are made, allowing the surgeon to use instruments to repair the hernia.
What does a indirect inguinal hernia feel like?
A burning or aching sensation at the bulge. Pain or discomfort in your groin, especially when bending over, coughing or lifting. A heavy or dragging sensation in your groin. Weakness or pressure in your groin.
What happens if a hernia is left untreated?
“Hernias cannot heal on their own — if left untreated, they usually get bigger and more painful, and can cause serious health risks in some cases.” If the wall through which the intestine is protruding closes shut, it can cause a strangulated hernia, which cuts off blood flow to the bowel.
Will my stomach shrink after hernia repair?
This appearance will not change with hernia repair. You will do best by dropping to your long-term stable weight (if you are not there already) prior to proceeding with any type of body contouring surgery.
How common is indirect inguinal hernia?
The incidence of inguinal hernias has a bimodal distribution, with peaks around age 5 and after age 70. Two-thirds of these hernias are indirect, making an indirect hernia the most common groin hernia in both males and females. Males account for about 90% of all inguinal hernias and females about 10%.
How is an indirect inguinal hernia treated?
Inguinal Hernia Treatment Surgery is the only way to fix an inguinal hernia. The doctor will push the bulging tissue back inside and strengthen your abdominal wall with stitches and perhaps mesh. They might be able to do this through a small cut in your belly using a special tool, a procedure called laparoscopy.
How is an indirect inguinal hernia diagnosed?
Your doctor will check for a bulge in the groin area. Because standing and coughing can make a hernia more prominent, you'll likely be asked to stand and cough or strain. If the diagnosis isn't readily apparent, your doctor might order an imaging test, such as an abdominal ultrasound, CT scan or MRI.
Why is indirect inguinal hernia common on right side?
Inguinal hernia is the most frequent problem requiring elective surgical intervention in children. Because of later descent of right testis and subsequently delayed obliteration of right processus vaginalis, inguinal hernia presents more frequently on the right side.
Where is an indirect inguinal hernia located?
Inguinal hernias are further subdivided into direct and indirect. An indirect hernia occurs when abdominal contents protrude through the internal inguinal ring and into the inguinal canal. This occurs lateral to the inferior epigastric vessels. The hernia contents may extend into the scrotum.
How is an indirect inguinal hernia diagnosed?
Your doctor will check for a bulge in the groin area. Because standing and coughing can make a hernia more prominent, you'll likely be asked to stand and cough or strain. If the diagnosis isn't readily apparent, your doctor might order an imaging test, such as an abdominal ultrasound, CT scan or MRI.
What are the types of hernia?
There are several types of hernia that you can experience including, inguinal hernias, femoral hernias, umbilical hernias and hiatal hernias.
Can adults get indirect inguinal hernias?
Indirect inguinal hernia. Although it can occur in men and women, it is much more common in men. This is because the male testicle starts inside the abdomen and has to go down through an opening in the groin area to reach the scrotum (the sac that holds the testicles).
Why do men have indirect inguinal hernias?
Men are much more likely to develop indirect inguinal hernias than women and the reason for this has always been assumed that the tunnel had to widen enough to allow the testicles to descend from the abdomen down to the scrotum. If one of the testicles does not descend, it is known as an undescended testicle.
How to tell if an infant has an indirect inguinal hernia?
For parents with infants with indirect inguinal hernias the bulge is usually noticed when the baby is crying. Pain is the next significant symptom. Sometimes this is a dull ache and other cases can present as a sharp pain.
Why does my inguinal canal hurt?
The narrow area can strangulate the tissue which is further herniated down the canal. This happens because the herniated bowel or fat starts to swell. This usually causes intense pain.
What is the most common type of groin hernia?
Indirect inguinal hernias are the most common type of groin hernia. Indirect inguinal hernias occur when abdominal content such as fat or bowel pushes down along the inguinal canal. What is the inguinal canal? It is the tunnel through which a man’s vas deferens and testicular vessels travel down into the scrotum.
What is a truss for a hernia?
A truss is usually made out of an elastic strap which goes around the waist and a part of the truss holds pressure against the bulging groin hernia. Hernia trusses are usually used in elderly patients or others who may not be good candidates for surgery due to their other medical problems.
Where are groin hernias located?
Femoral hernias, direct, and indirect inguinal hernias are groin hernias as they are located at just above the junction of the leg and the abdomen. We see at least 10 men with a groin hernia for every female that we see with a groin hernia.
Can an inguinal hernia be repaired without mesh?
Indirect inguinal hernias were historically repaired without mesh, but the recurrence rates were unacceptably high and the use of hernia mesh in the 1990’s became the standard. The mesh can be made of different materials. The choice of mesh material should be discussed with your surgeon if you have questions.
When does an indirect hernia occur?
An indirect hernia usually first occurs in infancy. That’s because it’s often a congenital condition. An indirect hernia in an infant may be most noticeable when the baby is crying. A direct hernia almost always develops in adulthood, usually later in life, unless the problem is the result of a specific injury.
How to reduce the risk of a hernia?
Lose weight if you’re overweight or obese. Weight loss won’t eliminate your risk of a hernia, but it will ease the strain on your abdominal muscles.
What is the most common type of hernia?
Inguinal hernias are the most common type of hernia. They form when there’s a thin spot on your abdominal wall.
What is the procedure called when a hernia is removed?
Laparoscopic surgery is a growing option for many types of abdominal surgeries, including hernia operations. A doctor uses special instruments that can be inserted through a few small incisions. One of the instruments is a tiny camera that allows the surgeon to see the hernia and treat it.
How is a hernia repaired?
In adults, open surgery is often done to repair a direct hernia. A large incision is made and the hernia is moved back into place. The abdominal wall is repaired, sometimes with a small mesh device that provides added strength to the affected wall.
How long does it take to recover from a hernia surgery?
Surgeries to repair hernias are common and have high success rates, so you should expect a full recovery. It may be several weeks before you’re back doing all your usual activities.
Is a hernia on one side of the groin a direct hernia?
That means a hernia that forms one side of the groin or the other is most likely a direct hernia. An indirect hernia may also cause bowel obstruction if it slips into the inguinal ring and becomes swollen in the abdomen.
Where do hernias occur?
There are many different types of hernias. An inguinal hernia is when a bulge or protrusion of tissue occurs in the groin area. They occur within the inguinal canal and can extend into the scrotum in males. The inguinal canal travels through the abdominal wall and is a passageway from the abdomen to the genitals.
How many premature babies have an indirect hernia?
Indirect hernia. Share on Pinterest. Indirect hernias affect up to 30 percent of premature babies. While a fetus is still in the womb, there is an internal opening to the inguinal canal, but this usually closes before birth.
How often should you have an inguinal hernia surgery?
undergoing the operation every year. Surgery does not always have to be immediate, but if an inguinal hernia is discovered, it must be monitored closely by a doctor to see if the symptoms get worse. If the tissue of the hernia becomes trapped or incarcerated, then surgery will be more urgent.
What is the most common type of inguinal hernia?
Indirect hernias are the most common type of inguinal hernia. Although they occur in both sexes, they are more more common in males than females.
How common is a hernia in men?
Most common in children, it affects up to 5 percent of newborns and up to 30 percent of premature babies. Often, it is discovered in the first year of life but can remain undetected until adulthood. Inguinal hernias are up to 10 times more more common in men than women and one in four men will develop a hernia at some point in their life.
What happens when the inguinal canal fails to close?
When the inguinal canal opening fails to close completely by the time of birth, this allows a portion of fat or intestine to slip through and cause an indirect hernia.
How many types of inguinal hernias are there?
There are two types of inguinal hernias:
How are indirect and direct hernias similar?
Indirect and direct inguinal hernias are similar in that they both present as bulges in the groin area. They also are both caused by organs pushing through the inguinal canal. However, indirect and direct hernias occur in different locations.
What is an indirect inguinal hernia?
They are more common in babies with testicles. 3 These hernias occur when one or both of the inguinal canals do not close during fetal development. 1
How do inguinal hernias differ from indirect hernias?
Direct hernias protrude through the posterior (back) wall of the inguinal canal. Indirect hernias protrude through the inguinal ring.
Why are inguinal hernias more common in testicles?
Direct inguinal hernias are also more common in people with testicles. That's because they have a wider inguinal canal than those with ovaries. As a result, over time, the canal is more likely to stretch out and become weak.
How common are inguinal hernias?
Inguinal hernias are quite common. In fact, 27% of people with testicles and 3% of people with ovaries will develop an in guinal hernia in their lifetime. 1
What causes a bulge in the groin area?
When that happens, part of the internal abdominal organs pushes through that canal, causing a bulge in the groin area.
Where do hernias protrude?
Direct hernias protrude through the back wall of the inguinal canal, while indirect hernias protrude through the inguinal ring.
What is an indirect hernia?
This is the congenital type of the sac. With incomplete descent of the testis ( undescended testis) there is usually an associated indirect hernial sac. Undescended testis is a common condition of infancy. It requires surgery to place the testis in the correct position. It may not be diagnosed early and this can cause problems. The testis in infancy, childhood and adolscence may undergo torsion ( another surgical emergency).
Where do indirect hernias protrude?
There are two basic types, but they both protrude through the superficial external ring of the inguinal canal in the groin. The INDIRECT descends along the spermatic cord in males from the deep internal ring. Or the round ligament in females. The indirect occur at any age, from infancy to the elderly. In children or females the hernia is invariably ...
Why should indirect hernias be surgically repaired?
Generally indirect herniae should be surgically repaired because they become larger, cause symptoms and may obstruct and strangulate.
How common are inguinal hernias?
Inguinal hernias are the most common type encountered in surgical practice (approx. 80%). They are far more common in men than women. They occur at any age – from the newborn to the elderly.
Why do you need a truss for a hernia?
A truss is sometimes used to prevent the hernia protruding and to minimise the discomfort. A truss is often used when the patient declines or is considered unfit for surgery.
Is an inguinal hernia in danger of strangulation?
This is a larger hernia in an elderly man descending into the scrotum. This hernia is in danger of strangulation. This is an average size right inguinal hernia. There is an obvious swelling in the right groin. Another indirect inguinal hernia.
Can a direct hernia cause a large hernia?
In children this is especially so because strangulation is more prone to occur with little warning. Direct herniae may not cause marked symptoms or become very large, nor do they obstruct or strangulate as frequently. However there can be no strict rule and direct hernias can complicate.
What is indirect inguinal hernia?
Indirect inguinal hernia. Indirect inguinal hernias (alternative plural: herniae), a type of groin herniation , are the most common type of abdominal hernia.
Where do indirect hernias protrude?
Indirect inguinal hernias arise lateral and superior to the course of the inferior epigastric vessels, lateral to Hesselbach's triangle, and then protrude through the deep or internal inguinal ring into the inguinal canal. An indirect hernia enters the inguinal canal at the deep ring, lateral to the inferior epigastric vessels.
How common is an inguinal hernia?
It is five times more common than a direct inguinal hernia , and is seven times more frequent in males, due to the persistence of the processus vaginalis during testicular descent. In children, the vast majority of inguinal hernias are indirect.
What are the complications of an inguinal hernia?
Complications include: incarceration. the most common complication associated with inguinal hernias, the incidence could be as high as 30% for infants younger than 2 months. strangulation with bowel ischemia and perforation. intestinal obstruction.
Is spermatic cord lipoma an indirect hernia?
On testicular ultrasound, one could consider spermatic cord lipoma on the differential if an inguinal hernia contains only omental fat. Movement of the fat with the Valsalva maneu ver is more likely an indirect hernia.
What is indirect hernia?
An indirect inguinal hernia is the most common type. It often occurs in premature births, before the inguinal canal becomes closed off. However, this type of hernia can occur at any time during your life. This condition is most common in males.
Where is an inguinal hernia?
What is an inguinal hernia? An inguinal hernia occurs in the abdomen near the groin area. They develop when fatty or intestinal tissues push through a weakness in the abdominal wall near the right or left inguinal canal. Each inguinal canal resides at the base of the abdomen. Both men and woman have inguinal canals.
What happens when tissue gets stuck in the groin?
An incarcerated inguinal hernia happens when tissue becomes stuck in the groin and isn’t reducible. This means it can’t be pushed back into place.
How to diagnose an inguinal hernia?
Your doctor can usually diagnose an inguinal hernia during a physical exam. During the exam, your doctor will ask you to cough while standing so they can check the hernia when it’s most noticeable.
What is the best treatment for an inguinal hernia?
Treating inguinal hernias. Surgery is the primary treatment for inguinal hernias. It’s a very common operation and a highly successful procedure when done by a well-trained surgeon. Options include either an open inguinal herniorrhaphy or laparoscopic inguinal herniorrhaphy.
What does it feel like to have a hernia in your groin?
They cause bulges along the pubic or groin area that can appear to increase in size when you stand up or cough. This type of hernia may be painful or sensitive to the touch. Other symptoms may include: pain when coughing, exercising, or bending over. burning sensations. sharp pain. a heavy or full sensation in the groin.
Where is the inguinal herniorrhaphy made?
In open inguinal herniorrhaphy, one larger incision is made over the abdomen near the groin. In laparoscopic inguinal herniorrhaphy, multiple smaller abdominal incisions are made. A long, thin tube with a lighted camera on the end helps the surgeon see inside your body to perform the surgery.
What is the term for a hernia in the abdomen?
Close. Inguinal hernia. Inguinal hernia. Inguinal hernias occur when part of the membrane lining the abdominal cavity (omentum) or intestine protrudes through a weak spot in the abdomen — often along the inguinal canal, which carries the spermatic cord in men. An inguinal her nia occurs when tissue, such as part of the intestine, ...
Where do hernias occur?
Inguinal hernias occur when part of the membrane lining the abdominal cavity (omentum) or intestine protrudes through a weak spot in the abdomen — often along the inguinal canal, which carries the spermatic cord in men.
What happens if you don't push a hernia in?
If you aren't able to push the hernia in, the contents of the hernia may be trapped (incarcerated) in the abdominal wall. An incarcerated hernia can become strangulated, which cuts off the blood flow to the tissue that's trapped. A strangulated hernia can be life-threatening if it isn't treated.
Why do inguinal hernias develop?
Other inguinal hernias develop later in life when muscles weaken or deteriorate due to aging, strenuous physical activity or coughing that accompanies smoking. Weaknesses can also occur in the abdominal wall later in life, especially after an injury or abdominal surgery.
How do you know if you have an inguinal hernia?
Inguinal hernia signs and symptoms include: A bulge in the area on either side of your pubic bone, which becomes more obvious when you're upright, especially if you cough or strain. A burning or aching sensation at the bulge. Pain or discomfort in your groin, especially when bending over, coughing or lifting.
Why do babies have hernias?
Inguinal hernias in newborns and children result from a weakness in the abdominal wall that's present at birth. Sometimes the hernia will be visible only when an infant is crying, coughing or straining during a bowel movement. He or she might be irritable and have less appetite than usual.
What to do if a hernia bulge turns red?
Seek immediate care if a hernia bulge turns red, purple or dark or if you notice any other signs or symptoms of a strangulated hernia.
Inguinal Hernia
An inguinal hernia occurs when soft tissue, such as that of the small intestine, pushes through a weakened point of the abdominal muscles. This usually happens in the groin area, which is located between the lower part of the abdomen and thigh. Inguinal hernias are the most common type of hernias in both sexes.
Symptoms of Direct vs. Indirect Hernia
Some people may not be aware that they have an inguinal hernia, because it can be present without symptoms. These cases are usually detected during a clinical examination. In children, an inguinal hernia may only be more noticeable when they cry, have a bowel movement, cough, or stands for long durations.
Difference Between Direct and Indirect Hernia
An indirect inguinal hernia is congenital and occurs because the inguinal ring, which closes off the inguinal canal, does not close at birth. Indirect hernias are known to cause pain in and swelling or enlargement of the scrotum when the intestine extends into the region.
Symptoms
Causes
Diagnosis
- Doctors diagnose indirect and direct inguinal hernias through a physical exam and sometimes through radiological tests. Your doctor will begin by taking a medical history. A physical exam involves visually observing the area and palpating (touching and pressing) to try to feel for a hernia. You will be asked to stand for the exam since the hernia may be more prominent when st…
Treatment
- Inguinal hernias do not heal on their own and can grow larger over time. That’s why surgical repair is the only treatment for inguinal hernias. Worldwide, more than 20 million people undergo surgery for groin hernias every year.4 Indirect and direct inguinal hernia surgery involves two steps:1 1. Moving the herniated tissue back into place 2. Repairing the weak area where the hernia occurre…
Prevention
- Since indirect inguinal hernias are often congenital, it is not possible to prevent them. However, there are some steps you can take to lower your risk of developing a direct inguinal hernia, including:3 1. Be careful when lifting heavy things. 2. Don’t strain when having a bowel movement. 3. Treat constipation(difficulty moving your bowels). 4. Treat a persistent cough. 5. Get treatme…
Summary
- Direct inguinal hernias occur through the posterior (back) wall of the inguinal canal, while indirect hernias protrude through the inguinal ring. Indirect inguinal hernias are often congenital, which means they are sometimes, though not always, diagnosed at birth. Both types of inguinal hernias are more common in people with testicles. The chief sy...
A Word from Verywell
- Rest assured that inguinal hernias are quite common. Most often, they are nothing to be alarmed about. That said, if you notice a bulge in your groin or your child's groin, it is important to have it evaluated by a doctor. The only treatment for indirect and direct inguinal hernias is surgery.