Inguinal hernia classification
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Classifications
There are two types of inguinal hernia, direct and indirect.
- Direct inguinal hernias occur when abdominal contents herniate through a weak point in the fascia of the abdominal wall and into the inguinal canal.
- Indirect inguinal hernias occur when abdominal contents protrude through the deep inguinal ring; this is ultimately caused by failure of embryonic closure of the internal inguinal ring.
Subtypes of inguinal hernias
| Type | Description | Relationship to inferior epigastric vessels | Covered by internal spermatic fascia? | Usual onset |
| indirect inguinal hernia | 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 | Lateral | Yes | Congenital |
| direct inguinal hernia | enters through a weak point in the fascia of the abdominal wall | Medial | No | Adult |
Inguinal hernias, in turn, belongs to groin hernias, which also includes femoral hernias. A femoral hernia is not via the inguinal canal, but via the femoral canal, which normally allows passage of the common femoral artery and vein from the pelvis to the leg.