Inguinal hernia pathophysiology: Difference between revisions

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{{Inguinal hernia}}


{{CMG}}; {{AE}} {{F.K}}
Editing Xyz pathophysiology
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{{CMG}}; {{AE}}
==Overview==
==Overview==
The exact pathogenesis of [disease name] is not fully understood.
Directed inguinal hernia is caused by protrusion through Hesselbach triangle, passes medial to inferior epigastric vessels. Indirected inguinal hernia is caused by passes through internal [[inguinal ring]], traverses [[inguinal canal]] to external ring, and may extend into [[scrotum]] in males and [[labia majora]] in females.
 
OR
 
It is thought that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3].
 
OR
 
[Pathogen name] is usually transmitted via the [transmission route] route to the human host.
 
OR
 
Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.
 
OR
 
 
[Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].
 
OR
 
The progression to [disease name] usually involves the [molecular pathway].
 
OR
 
The pathophysiology of [disease/malignancy] depends on the histological subtype.


==Pathophysiology==
==Pathophysiology==


===Pathogenesis===
===Pathogenesis===
*The exact pathogenesis of [disease name] is not fully understood.
*It is understood that indirect inguinal hernia is caused by:<ref name="pmid6353636">{{cite journal |vauthors=Berliner SD |title=Adult inguinal hernia: pathophysiology and repair |journal=Surg Annu |volume=15 |issue= |pages=307–29 |year=1983 |pmid=6353636 |doi= |url=}}</ref><ref name="pmid18244999">{{cite journal |vauthors=Jenkins JT, O'Dwyer PJ |title=Inguinal hernias |journal=BMJ |volume=336 |issue=7638 |pages=269–72 |year=2008 |pmid=18244999 |pmc=2223000 |doi=10.1136/bmj.39450.428275.AD |url=}}</ref>
OR
**Passes through internal inguinal ring, traverses [[inguinal canal]] to external ring
*It is understood that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3].
**May extend into scrotum in males and [[labia majora|labia major]] in females
*[Pathogen name] is usually transmitted via the [transmission route] route to the human host.
**Passes lateral to inferior epigastric vessels and has an [[oblique]] inferior course
*Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.
**Considered a congenital defect and associated with a patent [[processus vaginalis]]
*[Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].
*It is understood that directed inguinal hernia is caused by:
*The progression to [disease name] usually involves the [molecular pathway].
**Protrusion through Hesselbach triangle
*The pathophysiology of [disease/malignancy] depends on the histological subtype.
**Generally does not extend into [[scrotum]]  
**Passes medial to inferior epigastric vessels
**Considered an [[acquired]] defect


==Genetics==
*[Disease name] is transmitted in [mode of genetic transmission] pattern.
*Genes involved in the pathogenesis of [disease name] include [gene1], [gene2], and [gene3].
*The development of [disease name] is the result of multiple genetic mutations.


==Associated Conditions==
{{Family tree/start}}
{{Family tree |boxstyle=text-align: left; | | | | A01 | | | | A02 | |A01='''Predisposing factors'''<br>•Being male<br>•Having muscle weakness from birth along with a hernia sac<br>•Having muscle weakness from aging<br>•Having one or more inguinal hernia | A02='''Precipitating factors'''<br>•Being overweight or having a recent,large weight loss<br>•Having weak abdominal muscles from poor diet, lack of exercise or both<br>•Straining during urination or bowel movements<br>•Chronic cough,such as from smoking}}
{{Family tree | | | | |`|-|-|v|-|-|'| | | }}
{{Family tree | | | | | | | B01| | | | |B01=Incresed pressure in the compartment of the abdomen in develops}}
{{Family tree | | | | | | | |!| | | | | }}
{{Family tree | | | | | | | C01| | | | |C01=Intra-abdominal wall of inguinal canal into the scrotum becomes weakend}}
{{Family tree | | | | | | | |!| | | | | }}
{{Family tree | | | | | | | D01| | | | |D01=Causing the inguinal ring not to close}}
{{Family tree | | | | | | | |!| | | | | }}
{{Family tree | | | | | | | E01| | | | |E01=Evolves into a hole or defect}}
{{Family tree | | | | | | | |!| | | | | }}
{{Family tree | | | | | | | F01| | | | |F01=Fat or part of the small intestine slides through the inguinal canal}}
{{Family tree | | |,|-|-|-|-|+|-|-|-|-|.| }}
{{Family tree | | G01| | | G02 | | | | G03| |G01=Swollen or enlarged scrotum| G02=Feeling of weakness or pressure in the groin| G03=Pain or discomfort}}
{{Family tree/end}}


==Gross Pathology==
==Genetics==
*On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
*Genes involved in the [[pathogenesis]] of inguinal hernia include microdeletion disorders such as 22q11.2 microdeletion.<ref name="pmid19573673">{{cite journal |vauthors=Barnett C, Langer JC, Hinek A, Bradley TJ, Chitayat D |title=Looking past the lump: genetic aspects of inguinal hernia in children |journal=J. Pediatr. Surg. |volume=44 |issue=7 |pages=1423–31 |year=2009 |pmid=19573673 |doi=10.1016/j.jpedsurg.2008.12.022 |url=}}</ref>


==Microscopic Pathology==
==Microscopic Pathology==
*On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
*On microscopic histopathological analysis, inflammatory infiltration, [[vascular]] damage and regressive nerve lesions, fibrohyaline [[degeneration]] and fatty [[dystrophy]] of the muscle fibers are characteristic findings of inguinal hernia. <ref name="pmid23288217">{{cite journal |vauthors=Amato G, Agrusa A, Romano G, Salamone G, Cocorullo G, Mularo SA, Marasa S, Gulotta G |title=Histological findings in direct inguinal hernia : investigating the histological changes of the herniated groin looking forward to ascertain the pathogenesis of hernia disease |journal=Hernia |volume=17 |issue=6 |pages=757–63 |year=2013 |pmid=23288217 |doi=10.1007/s10029-012-1032-0 |url=}}</ref>


==References==
==References==

Latest revision as of 15:15, 29 January 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Farima Kahe M.D. [2]

Overview

Directed inguinal hernia is caused by protrusion through Hesselbach triangle, passes medial to inferior epigastric vessels. Indirected inguinal hernia is caused by passes through internal inguinal ring, traverses inguinal canal to external ring, and may extend into scrotum in males and labia majora in females.

Pathophysiology

Pathogenesis

  • It is understood that indirect inguinal hernia is caused by:[1][2]
    • Passes through internal inguinal ring, traverses inguinal canal to external ring
    • May extend into scrotum in males and labia major in females
    • Passes lateral to inferior epigastric vessels and has an oblique inferior course
    • Considered a congenital defect and associated with a patent processus vaginalis
  • It is understood that directed inguinal hernia is caused by:
    • Protrusion through Hesselbach triangle
    • Generally does not extend into scrotum
    • Passes medial to inferior epigastric vessels
    • Considered an acquired defect


 
 
 
Predisposing factors
•Being male
•Having muscle weakness from birth along with a hernia sac
•Having muscle weakness from aging
•Having one or more inguinal hernia
 
 
 
Precipitating factors
•Being overweight or having a recent,large weight loss
•Having weak abdominal muscles from poor diet, lack of exercise or both
•Straining during urination or bowel movements
•Chronic cough,such as from smoking
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Incresed pressure in the compartment of the abdomen in develops
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Intra-abdominal wall of inguinal canal into the scrotum becomes weakend
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Causing the inguinal ring not to close
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Evolves into a hole or defect
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Fat or part of the small intestine slides through the inguinal canal
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Swollen or enlarged scrotum
 
 
Feeling of weakness or pressure in the groin
 
 
 
Pain or discomfort
 

Genetics

  • Genes involved in the pathogenesis of inguinal hernia include microdeletion disorders such as 22q11.2 microdeletion.[3]

Microscopic Pathology

  • On microscopic histopathological analysis, inflammatory infiltration, vascular damage and regressive nerve lesions, fibrohyaline degeneration and fatty dystrophy of the muscle fibers are characteristic findings of inguinal hernia. [4]

References

  1. ↑ Berliner SD (1983). "Adult inguinal hernia: pathophysiology and repair". Surg Annu. 15: 307–29. PMID 6353636.
  2. ↑ Jenkins JT, O'Dwyer PJ (2008). "Inguinal hernias". BMJ. 336 (7638): 269–72. doi:10.1136/bmj.39450.428275.AD. PMC 2223000. PMID 18244999.
  3. ↑ Barnett C, Langer JC, Hinek A, Bradley TJ, Chitayat D (2009). "Looking past the lump: genetic aspects of inguinal hernia in children". J. Pediatr. Surg. 44 (7): 1423–31. doi:10.1016/j.jpedsurg.2008.12.022. PMID 19573673.
  4. ↑ Amato G, Agrusa A, Romano G, Salamone G, Cocorullo G, Mularo SA, Marasa S, Gulotta G (2013). "Histological findings in direct inguinal hernia : investigating the histological changes of the herniated groin looking forward to ascertain the pathogenesis of hernia disease". Hernia. 17 (6): 757–63. doi:10.1007/s10029-012-1032-0. PMID 23288217.

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