QS Study

When the contents of a hernia enter the inguinal canal not through the deep ring, but through the posterior wall, it is called direct hernia. It is usually caused when the wall of the abdominal muscles becomes weak. It is most common in adult males and rare in children. These usually occur in adult males. Aging and stress or strain can weaken the muscles around the inguinal canal.

Since direct hernias do not have a guiding path, they seldom extend into the scrotum unless very large and chronic.

Fig: Direct Inguinal Hernia

Direct inguinal hernia features –

  • Age of onset: Usually in an elderly person.
  • Sex: Female rare.
  • Entrance: Through floor of Hasselbach’s triangle.
  • Exit: Rarely through a superficial inguinal ring.
  • Extent: Usually incomplete
  • Reducibility: Reduces spontaneously.
  • Deep ring Occlusion test: Negative (-ve)
  • Obstruction and strangulation:
  • Invagination test: Impulse felt on the pulp of the finger.
  • Shape: Globular.