QS Study

When the contents of a hernia enter the inguinal canal by passing through the deep inguinal ring, it is called an indirect inguinal hernia. It occurs when an area of abdominal muscle tissue called the inguinal ring fails to close up while a baby is in the mother’s womb. In boys, the ring allows the testicles to drop into the scrotum, and then usually closes.

Most common in children, it affects up to 5 percent of newborns and up to 30 percent of premature babies. In females, the ovaries and other parts of the reproductive system can slide through the opening and cause a hernia.

Fig: Indirect Inguinal Hernia

Indirect inguinal hernia

  • Age of onset: Any age, common in infants, children, and young adults
  • Sex: Male more common, but a female may suffer.
  • Entrance: Through deep inguinal ring.
  • Exit: Maybe through a superficial inguinal ring.
  • Extent: Usually incomplete or complete.
  • Reducibility: Gradually reduces.
  • Deep ring Occlusion test: Positive (+ve).
  • Obstruction and strangulation:
  • Invagination test: Impulse felt on the tip of the finger.
  • Shape: Piriform