),and their repair is one of the most frequentlyperformedsurgicaloperations. There are two types of inguinalhernia,
, which aredefined by their relationship to the inferiorepigastric vessels. Direct inguinal herniasoccur medial to the inferior epigastric vesselswhen abdominal contents herniate throughtheexternal inguinal ring. Indirect inguinalhernias occur when abdominal contentsprotrude through thedeep inguinal ring, lateralto the inferior epigastric vessels; this may becaused by failure of embryonic closure of theprocessus vaginalis.OriginIn men, indirect hernias follow the same routeas the descendingtestes, which migrate fromtheabdomeninto the scrotum duringthedevelopment of the urinary andreproductive organs. The larger size of of Africandescent. Among adults, it is threetimes more common in women than in men;among children, the ration is roughly equal. Anacquired umbilical hernia directly results fromincreased intra-abdominal pressure and aremost commonly seen in obese individuals.PresentationAherniais present at the site of theumbilicus(commonly called a navel, or bellybutton) in the newborn; although sometimesquite large, these hernias tend to resolvewithout any treatment by around the age of 5years.
Obstruction and strangulation of the hernia is rare because the underlying defectin the abdominal wall is larger than inaninguinal herniaof the newborn. The size of the base of the herniated tissued is inverselycorrelated with risk of strangulation (i.e. narrowbase is more likely to strangulate).Babies are prone to this malformation becauseof the process duringfetal developmentbywhich the abdominal organs form outside theabdominal cavity, later returning into it through
theiringuinal canal, which transmitted thetesticle and accommodates the structures of thespermatic cord, might be one reason whymen are 25 times more likely to have aninguinal hernia than women. Although severalmechanisms such as strength of the posteriorwall of the inguinal canal and shuttermechanisms compensating for raised intra-abdominal pressure prevent hernia formationin normal individuals, the exact importance of each factor is still under debate.an opening which will become the umbilicus.