Inguinal hernia - Basics - Classification - Best Practice - English

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Inguinal hernia Classification

Anatomical
Inguinal hernias are classified into either direct or indirect, based on the relationship of the sac to the inferior epigastric artery. 1. Direct - hernial sac lies medial to the artery and the deep inguinal ring. 2. Indirect - hernial sac lies lateral to the artery. Inguinal hernia may be further sub-classified into the 5 following groups: Reducible hernia - the contents of the hernia may be reduced completely into the peritoneal cavity Irreducible hernia - the contents may not be reduced into the peritoneal cavity. The inability to reduce the content often occurs as a result of adhesion between the contents and the inner wall of the containing sac Obstructed hernia - irreducible hernia in which the bowel blood supply is not yet compromised Strangulated hernia - obstructed hernia in which the blood supply is compromised. Unless relieved, gangrene and perforation of the affected segment of bowel ensues. A strangulated hernia can have omentum or other viscera in the sac Incarcerated hernia - term is used to refer to different types or stages including irreducible hernia, obstructed or strangulated hernia. This term lacks precision and so should not be used to describe a complicated hernia.

Anatomical sub-classification [1]

Bubonocele - inguinal hernia confined to the inguinal canal. Funicular - hernial sac extending beyond the superficial ring but not reaching the scrotum. Complete (scrotal) - hernial sac reaches the scrotum. The testis is in the lower end of the hernial sac.

Nyhus classification [2]

Type 1 - indirect inguinal hernia with normal internal ring. Type 2 - indirect hernia with dilated internal ring but normal posterior inguinal wall. Type 3 - posterior wall defects Direct hernia Indirect hernia with dilated internal ring and weakness of posterior wall Femoral hernia. Type 4 - Recurrent inguinal hernia.
Last updated: Oct 21, 2011 Discuss this topic on the Surgery forum at doc2doc Discuss this topic on the Medicine forum at doc2doc

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03/10/2012 07:10