Types of Inguinal hernias
Inguinal hernias come in three main types, understanding of which requires a grasp of the anatomy of the groin area:
1. **Indirect Inguinal Hernia**
2. **Direct Inguinal Hernia**
3. **Femoral Hernia**
The groin area contains a structure called the inguinal canal, which serves as a passageway from the inside to the outside of the abdominal wall. In males, this canal is used during fetal development for the testicles to descend from the abdomen to the scrotum. The entrance on the inside of the abdominal wall to this canal is called the internal inguinal ring, and the exit on the outside is called the external inguinal ring. Additionally, the lower abdominal wall is traversed by important blood vessels, with the internal inguinal ring located outside these vessels.
The Three Types of Hernias:
1. **Indirect Inguinal Hernia (Indirect Hernia):**
This type occurs when the intestines or other abdominal contents protrude through the inguinal canal, enveloped by the peritoneum. They exit through the internal inguinal ring, situated outside the lower abdominal wall vessels, hence the name indirect. This is the most common type of inguinal hernia.
2. **Direct Inguinal Hernia (Direct Hernia):**
Unlike indirect hernias, direct inguinal hernias do not pass through the inguinal canal. Instead, they protrude directly through a weakened area in the abdominal wall, specifically the area inside the lower abdominal wall vessels known as the Hesselbach triangle, hence the name direct.
3. **Femoral Hernia:**
Femoral hernias protrude through the femoral ring, located just below the Hesselbach triangle. They are less common compared to inguinal hernias.
Treatment:
For all three types of inguinal hernias, surgery is the only definitive treatment. It's difficult for patients to distinguish between the types on their own, and the treatment approach does not vary significantly across types.
Symptoms across all types are similar, with the hernia often starting as a bulge in the groin that becomes progressively larger and painful, eventually leading to discomfort that can interfere with daily activities.
Inguinal hernias will not heal on their own, and without treatment, they will likely worsen rather than improve. No medications or physical therapies can cure hernias. While some people may use hernia belts (trusses) for temporary relief, these do not treat the hernia and the protrusion will return once the belt is removed.
Additionally, untreated hernias risk becoming incarcerated, meaning the trapped intestine cannot return to the abdominal cavity, posing a life-threatening situation.
It is crucial to seek proper treatment before the condition escalates to this critical state.