An inguinal hernia is the most common form of hernia. It must always be treated surgically, as otherwise it can lead to serious complications such as intestinal incarceration.
You can find further information and qualified inguinal hernia specialists here.
An inguinal hernia is a hernia in the area of the inguinal canal. It is also known as an inguinal hernia.
A gap forms in the abdominal wall in the groin area . Through this gap, parts of the intestines that are still enclosed by the peritoneum protrude outwards from the abdominal cavity. This gap in the abdominal wall is also known as the hernial orifice.
The peritoneum, which bulges outwards through the hernial orifice in the abdominal wall like a sac with the viscera it contains, forms the so-called hernial sac. The protruding viscera enclosed in the peritoneum, including parts of the intestine for example, form the so-called hernia contents.
Occurrence and presentation of an inguinal hernia © designua | AdobeStock
Every year, around 0.5 percent of the population suffers a hernia in the area of the inguinal canal. The inguinal hernia is therefore one of the most common surgical diseases in humans.
It is also the most common type of hernia, as around 75 to 80 percent of all hernias are inguinal hernias. Men are affected much more frequently than women: Around 80 percent of all inguinal hernias occur in men.
A basic distinction can be made between a congenital and an acquired inguinal hernia. Acquired means that the disease only occurs in the course of life.
A distinction must also be made between direct and indirect inguinal hernias. They are classified according to the location of the hernial orifice and the direction in which the hernial sac passes through the hernial orifice in the groin area.
A direct inguinal hernia, also known as a medial inguinal hernia, is usually acquired and occurs mainly in older men. The hernia sac protrudes directly vertically through the hernial orifice out of the abdominal cavity on the posterior wall of the inguinal canal.
An indirect inguinal hernia, also known as a lateral inguinal hernia, is usually congenital. In this form of inguinal hernia, the hernia sac protrudes along the spermatic cord (in men) or the maternal ligament (in women) through the inner opening of the inguinal canal into the inguinal canal. Around two thirds of all inguinal hernias are indirect inguinal hernias.
Inguinal hernia in a male patient © Prof. Dr. med. Thomas W. Kraus
An inguinal hernia occurs due to a weak point in the abdominal wall in the area of the inguinal canal. The causes differ depending on whether the hernia is congenital or acquired.
In the case of a congenital inguinal hernia, the underlying weakness is due to incomplete internal closure of the abdominal wall during early childhood.
The underlying weakness in an acquired inguinal hernia can be caused by abdominal surgery and a congenital weakness of the connective tissue, among other things.
The triggering events and risk factors that can cause an acquired inguinal hernia include chronically increased pressure in the abdominal cavity, for example when
pregnancy and obesity.
Lifting heavy loads increases the pressure in the abdomen © BalanceFormCreative | AdobeStock
An inguinal hernia typically manifests itself as a visible and palpable bulge in the groin area. It can usually be easily pushed back inwards. It is particularly noticeable in the evening or after physical exertion.
In addition, an inguinal hernia often causes symptoms such as a feeling of pressure and slight pulling pain in the groin area. They intensify when there is an increase in pressure in the abdomen, for example when
An inguinal hernia can lead to serious complications if the intestines in the hernial sac become trapped in the hernial orifice. In this case, severe pain and sometimes nausea and vomiting occur. In the worst case, there is a risk of intestinal obstruction, which can lead to a ruptured intestine and peritonitis.
First of all, the doctor conducts a medical history interview with the patient. He asks specific questions about the patient's symptoms and complaints. This is followed by a physical examination, during which the doctor examines and carefully palpates the patient's groin region.
In addition, further examinations such as an ultrasoundscan (sonography) or magnetic resonance imaging(MRI) can be carried out to diagnose a hernia. These imaging procedures allow the doctor to better assess the inguinal hernia and rule out other diseases.
An inguinal hernia is usually treated surgically as part of hernia surgery. Independent recovery without treatment is not possible. The operation is necessary because the hernia enlarges over time and there is a risk of entrapment of parts of the intestine.
Conservative treatment is only attempted in patients at risk, e.g. those who are very old or have serious concomitant illnesses. As a rule, doctors do not think much of hernia ligaments.
Inguinal hernia operated on with mesh using the Lichtenstein procedure © Prof. Dr. med. Thomas W. Kraus
Inguinal hernia surgery is performed either
The surgeon first moves the hernia contents back into the abdominal cavity. He then closes the hernial orifice in the abdominal wall.
The hernial orifice is closed either by suturing or with a mesh.
In the suture procedure, the hernia is treated and reinforced with sutures. However, a lightweight plastic mesh is used much more frequently.
Take a look at a minimally invasive inguinal hernia operation with mesh (Lichtenstein procedure) performed by Prof. Dr. Thomas W. Kraus.
