Groin Hernia 1

GROIN HERNIAS

4.1 Development of Inguinal Canal

The   descent   of   the  testis   from   its   intra   abdominal

retroperitoneal  position  into the scrotum is via  the  inguinal

canal.

A  diverticulum  of  the  perietal  peritoneuum,  the   Processus

vaginalis  accompanies  the  testicle, its  connection  with  the

abdominal peritoneium is obliterated in utero or in early infancy

Fig. above

The  spermatic cord passes obliquely downward through an  opening

in  the  transversalis  fascia  (the  inner  most  layer  of  the

abdominal wall) into the inguinal canal at the internal  inguinal

ring,  here the fascia continues into the inguinal canal  as  the

internal spermatic fascia.

The cord running obliquely downward, emerges through the external

inguinal  ring;  an opening in the aponeurosis  of  the  external

oblique, just above the scrontum.  The entire canal is 4 cm  long

and  is  2-4  cm above and parallel  to  the  inguinal  ligament.

Weakness at the internal ring or the posterior wall can result in

injunal hernias.

4.2 An indirect inguinal hernia with its sac leaves the abdominal

cavity at the internal ring and passes medial to the stuctures of

the  permatic  cord  either  remaining  in  the  inguinal   canal

(bubobnocele)  or  descends all the way into  the  scrotum.   The

indirect hernia lies within the fibres of the cremaster muscle.

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