When it comes to multiple ipsilateral inguinal hernia, possible for a person to develop 2 indirect hernia? Cause I was told that’s not possible as there’s only one orifice at the deep ring. I couldn’t find a useful article to help me with this. Please help..
I have never seen multiple indirect inguinal hernias on the same side.
There is indeed only one deep ring so when it opens it becomes the one and only source of an indirect inguinal hernia.
You can indeed have an indirect inguinal hernia and also a direct inguinal hernia on the same side which we term a pantaloon hernia. This is where the deep ring opens and also the posterior wall fails simultaneously.
You can have a femoral hernia simultaneously as well.
So I agree, it is not possible to have multiple indirect inguinal hernias on the same side of the same patient.
I think you can certainly have an indirect inguinal hernia and a cord lipoma co-existing. But I am not sure about the cord lipoma passing in and out f the deep ring. The cord lipoma is by definition attached to the cord and hence can only move a very short distance. When you see a cord lipoma and ask the patient to strain they do move slightly within the canal, but not far. I think if the fat is passing through the deep ring into the canal and back again it is more likely a true indirect hernia rather than a cord lipoma.