inguinal hernia

[SUMAN-SAJAN]

Is the indirect inguinal hernia within the spermatic cord or by the side ?

In Norman L. Browse its said it is found inside the spermatic cord .............but i got confused.

Someone please resolve my confusion.

[Anup'da]

hey suman,,

i got stuck in the same question when i was posted in surgery department.

as per the book " principles and practice of surgery", 4th edition,in page 190
it's given as the hernial content pass into the coverings of spermatic cord to reach scrotum.

u can make quick reference from other books if u like. i think this resolves the question.

[JNUS]

spermatic cord forms the floor of the sac of hernia, that means that hernial sac is by side of the spermatic cord, but both are embedded within the fascial tissue , which is commonly said to be spermatic cord and so some writers are fond of writing hernial sac within the spermatic cord.

[SUMAN-SAJAN]

Thanks JNUS

[Anup'da]

well jnus dai,

but in the book principles and practice of surgery, it's written as such" an indirect inguinal hernia enters the internal inguinal ring and descends within the coverings of the spermatic cord so that it can pass on down into scrotum. the hernia may remain within the inguinal canal(bubonocele), protrude through the external ring (funicular) or extend into the scrotum(complete or scrotal)." so probably hernial sac is within the cord, and spermatic cord may not be the floor as u've said.

i think we'd a great confusion here regarding the topic. but that's what written in that book.

[SUMAN-SAJAN]

The most common groin hernia, the indirect inguinal hernia is a type of inguinal hernia which protrudes through the inguinal ring and is ultimately the result of the failure of embryonic closure of the internal inguinal ring after the testicle passes through it. In the fetus, the peritoneum gives a coat to the testicle as it passes through this ring, forming a temporary connection called the processus vaginalis. In normal development, the processus is obliterated once the testicle is completely descended. The permanent coat of peritoneum that remains around the testicle is called the tunica vaginalis. The testicle remains connected to its blood vessels and the vas deferens, which make up the spermatic cord and descend through the inguinal canal to the scrotum.

The internal inguinal ring, which is the beginning of the inguinal canal, remains as an opening in the internal oblique muscle, which forms the muscular outer wall for the spermatic cord. When the opening is larger than necessary for passage of the spermatic cord, the stage is set for an indirect inguinal hernia. The protrusion of peritoneum through the internal inguinal ring can be considered an incomplete obliteration of the processus. A hernia occurs when intra-abdominal contents, commonly including preperitoneal fatty tissues, abdominal fluid if present, the peritoneum itself, and eventually omentum and intestines, traverse the ring to enter the inguinal canal. As time passes, the hernia contents may enlarge, extend the length of the canal, and even exit the canal through the external inguinal ring, an opening in the external oblique fascia, into the scrotum.

A second means of indirect inguinal hernia formation in the spermatic cord is a failure of the processus vaginalis to close properly.


FROM WIKIPEDIA