(Groin Hernia)

..
3
1. Direct Inguinal hernia
2. Indirect Inguinal hernia
3. Femoral hernia

2 5
4 1. Pubic tubercle
6
2. Anterior superior iliac spine
1 3. Inguinal ligament
4. Inguinal canal
3 5. Internal ring
7
6. External ring
7. Femoral ring



1. pubic tubercle inguinal ligament
Femoral hernia
2. inguinal ligament Direct inguinal hernia Indirect
inguinal hernia
3. inguinal ligament Indirect inguinal
hernia

1. Femoral Hernia
2. Direct Inguinal Hernia or
2
Indirect Inguinal Hernia
3. Indirect Inguinal Hernia
1
3

1. Temperature and tenderness

strangulated hernia abscess orchitis
2. Palpate the testis

axis
 undescended testis torsion testis
testicular tumor
3. Get above the swelling test

4. Consistency


- Soft and elastic : bowel
- Firm and doughy : omentum
- Tense and tender : strangulated hernia
- Bag of worms feel : varicocele
5. Test reducibility
incarcerated hernia


( strangulated hernia )
internal ring

6. Invagination test (Impingement test)

inguinal canal
incarcerated hernia (
) external
ring inguinal canal ( external ring
) inguinal canal
(Valsalvas maneuver) indirect inguinal hernia
direct inguinal hernia
7. Internal ring occlusion test
internal ring (1-2
midpoint of inguinal ligament)
 indirect inguinal hernia direct inguinal
hernia
8. Ziemans technique
3 internal ring
external ring femoral ring
indirect inguinal hernia direct inguinal hernia
femoral hernia ()

1. Quinn TH. Anatomay of the Groin: A View from the Anatomist. In: Robert J. Fitzgibbons J, A.
Gerson Greenburg. Nyhus and Condon's Hernia 5th ED. Philadelphia: Lippincott Williams and
Wilkins; 2002.55-70.
2. Mark A, Malangoni MJR. Hernias. In: Courtney M. Townsend J. Sabiston Textbook of surgery
The Biological Basis of Modern Surgical Preactice. 18th ED. Texas: Saunders; 2008.1155-1179.
3. Sherman V, Macho JR, Brunicardi CF. Inguinal Hernias. In: F. Charles Brunicardi. Schwartzs
Principle of Surgery. 9th ED. New York, McGraw-Hill; 2009:1305-1342.