> [!key points]
> - any hernia that becomes painful, inflamed, or tender -- and is not readily reducible -- should be regarded as a surgical emergency
> - common cause of [[Bowel obstruction|small bowel obstruction]]
| term | definition |
| ---------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Direct inguinal hernia | - acquired, weakness of anterior abdominal wall, traverses medial 1/3 of canal, exits superficial inguinal ring lateral to the cord. does Not enter deep inguinal ring<br>- rarely enters scrotum. <br>- usually older age group <br>- medial to inferior epigastric artery, often within hesselbach's triangle |
| Indirect inguinal hernia | - congenital<br>- traverse entire inguinal canal from internal to external inguinal ring, inside the cord<br>- *commonly into scrotum or labium* <br>- lateral to inferior epigastric artery<br>- all [[neonatal bowel obstruction]] are indirect |
| femoral hernia | - 20% groin hernias in females; 1% in males<br>- older > younger<br>- hernia sac passes through femoral canal<br>- cough impulse below pubic tubercle<br>- small lump may be palpable anterior or medial to femoral artery<br>- contents are prone to ischaemia |
| Richter's hernia | - typical of femoral hernias, where *only a portion of the circumference of the bowel is strangulated* <br>- because the intestinal lumen is not completely blocked, bowel obstruction may not occur and presentation can be delayed and non-specific<br>- ∴ segment of bowel may be ischaemic and perforate<br>- signs of strangulation without obstruction |
| incarceration / <br>adhesion | irreducible |
| strangulation | ischaemia; circulation is compromised<br>- ↑ pain<br>- tenderness<br>- warmth<br>- ↑ oedema<br>- overlying erythema |
![[Pasted image 20241222144213.png]]