Case -?Direct Hernia

[Diane]

Hi Steve,
I scanned a male’s groin who had persisting groin pain with known hernia. His hernia was previously scanned and reported as an indirect hernia. When I scanned him, I was thinking it was more a direct hernia as I believe there was no expansion of the deep ring upon stress.

Cine loops attached.

Any thoughts? 🙂

Thank you

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[Stephen Bird]

Howdy,

These are interesting.

To me it simply looks like the posterior wall of the canal is very lax.

I agree there is nothing coming through the deep ring.

The movement is coming from below.

The question in my mind with these cases is “is there a defect in the posterior wall of the canal?”

\To me it looks like the posterior wall is actually intact and no fat actually enters the canal and hence the fat does not extend through the superficial ring as the posterior wall is actually intact.

To make a comparison it is more like a diverication of the linea alba than a ventral hernia.

The posterior wall bulges forward rather than having a hole in it.

I report these as “gross laxity of the posterior wall” but I know some people still call these direct inguinal hernias.

For me q true hernia requires a hole for fat to pass through rather than a simple weakness.

Steve.

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