Inguinal hernia classification: Difference between revisions
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==Classification== | ==Classification== | ||
*Inguinal hernia may be classified into several subtypes based on: | *Inguinal hernia may be classified into several subtypes based on:<ref name="pmid15851379">{{cite journal |vauthors=Holzheimer RG |title=Inguinal Hernia: classification, diagnosis and treatment--classic, traumatic and Sportsman's hernia |journal=Eur. J. Med. Res. |volume=10 |issue=3 |pages=121–34 |year=2005 |pmid=15851379 |doi= |url=}}</ref> | ||
**Nyhus classification | **Nyhus classification | ||
**Gilbert classification | **Gilbert classification | ||
Revision as of 20:52, 22 January 2018
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Inguinal hernia classification On the Web |
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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
Inguinal hernia may be classified according to integrity of the posterior wall and the deep inguinal ring into 4 groups.Inguinal hernia may be classified according to presence or absence of a peritoneal sac, size of the internal ring and integrity of the posterior wall of the canal into 5 groups.
Classification
- Inguinal hernia may be classified into several subtypes based on:[1]
- Nyhus classification
- Gilbert classification
- Casten classification
- McVay classification
- Inguinal hernia may be classified according to the integrity of the posterior wall and the deep inguinal ring, Nyhus classification, into 4 groups:
- Type 1: indirect inguinal hernia with a normal inguinal ring, peritoneal sac is in the inguinal canal
- Type 2: indirect hernia with an enlarged deep inguinal ring with the posterior wall intact, sac not in the scrotum
- Type 3: posterior wall (inguinal floor) defects:
- Type 3a: direct hernia with a posterior floor defect only
- Type 3b: indirect hernia with enlargement of deep inguinal ring and posterior floor defect
- Type 3c: femoral hernia
- Type 4: recurrent hernia
- Inguinal hernia may be classified according to the presence or absence of a peritoneal sac, size of the internal ring and integrity of the posterior wall of the canal, Gilbert classification, into 5 groups:
- Type 1 hernias have a peritoneal sac passing through an intact internal ring that will not admit 1 fingerbreadth (ie,<1 cm.); the posterior wall is intact.
- Type 2 hernias (the most common indirect hernia) have a peritoneal sac coming through a 1-fingerbreadth internal ring (ie, ≤2 cm.); the posterior wall is intact.
- Type 3 hernias have a peritoneal sac coming through a 2-fingerbreadth or wider internal ring (ie, >2 cm.).
- Type 3 hernias frequently are complete and often have a sliding component. They begin to break down a portion of the posterior wall just medial to the internal ring.
- Type 4 hernias have a full floor posterior wall breakdown or multiple defects in the posterior wall. The internal ring is intact, and there is no peritoneal sac.
- Type 5 hernias are pubic tubercle recurrence or primary diverticular hernias.
NOTE: Types 1, 2 and 3 are indirect hernias; types 4 and 5 are direct.
- Inguinal hernia may be classified according to Casten method into 3 stages:
- Stage 1: an indirect hernia with a normal internal ring
- Stage 2: an indirect hernia with an enlarged or distorted internal ring
- Stage 3: all direct or femoral hernias
- Inguinal hernia may be classified according to McVay method into 4 classes:
- Class 1: small indirect hernia
- Class 2: medium indirect hernia
- Class 3: large indirect hernia or direct hernia
- Class 4: femoral hernia