How to distinguish direct inguinal hernia from indirect inguinal hernia?

summary

Inguinal hernia is a common and frequently occurring disease in surgical clinic. As a surgeon, it is often encountered. In clinical practice, most doctors have made great efforts to distinguish indirect inguinal hernia from direct inguinal hernia, and sometimes they are always arguing about some cases that are not easy to distinguish. In fact, there are many cases of indirect inguinal hernia and direct inguinal hernia before operation is not clear, only in the operation has been confirmed, that is, the hernia sac located in the lateral inferior epigastric artery is indirect hernia, located in the medial inferior epigastric artery is direct hernia. Let's share my experience with you.

How to distinguish direct inguinal hernia from indirect inguinal hernia?

Age of onset: indirect hernia is more common in children and young adults, and direct hernia is more common in the elderly. Protruding way: indirect hernia is protruding through inguinal canal, which can enter scrotum; But the direct hernia is protrudes through the direct hernia triangle, does not enter the scrotum.

The shape of hernia mass: the indirect hernia is oval or pear shaped, and the upper part is pedunculated; The direct hernia is hemispherical with wide base. Compression of deep ring (internal orifice) test: after the indirect hernia was retracted, the deep ring was pressed, the intra-abdominal pressure was increased, and the hernia block was no longer protruding; However, when the direct hernia pressed the deep ring, the intra-abdominal pressure was increased, and the hernia mass was still prominent.

The relationship between spermatic cord and hernia sac: the spermatic cord of indirect hernia is behind the hernia sac; The spermatic cord of direct hernia is outside the hernia sac. The relationship between the neck of hernia sac and inferior epigastric artery: the neck of hernia sac is outside the inferior epigastric artery; The neck of the hernia sac is in the medial side of the inferior epigastric artery. Incarceration chance: indirect hernia is more common, direct hernia is less.

matters needing attention

In the diet must also control the salt intake, do not eat spicy food such as coffee, strong tea, you can eat more cereals such as cereals, oats or soybeans, you can drink more water or milk, but do not drink carbonated drinks.