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General Surgery
Published in Kristen Davies, Shadaba Ahmed, Core Conditions for Medical and Surgical Finals, 2020
Inguinal hernias are classified by where in the inguinal canal they emerge and their position relative to the inferior epigastric vessels (which branch from the external iliac) in Hesselbach's triangle. Knowledge of the relevant anatomy is crucial for differentiating between inguinal and femoral hernias (Figures 12.3.1, 12.3.2).
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Published in Andrew Schofield, Paul Schofield, The Complete SAQ Study Guide, 2019
Andrew Schofield, Paul Schofield
Inguinal hernias are the commonest form of hernia. Indirect hernias pass through the internal inguinal ring into the inguinal canal, and if large enough, through the external inguinal ring into the scrotum. Direct inguinal hernias protrude directly through the abdominal wall into the inguinal canal. Indirect hernias comprise 80% of inguinal hernias, and direct hernias make up the remaining 20%. These hernias may be repaired electively unless the hernia becomes incarcerated, obstructed or strangulated, when the repair must be done as an emergency.
The male reproductive system and hernias
Published in Peter Kopelman, Dame Jane Dacre, Handbook of Clinical Skills, 2019
Peter Kopelman, Dame Jane Dacre
A direct inguinal hernia, by contrast, results from an acquired weakness of the posterior wall of the inguinal canal. It therefore arises medial to the internal inguinal ring, usually remains confined within the canal and never extends to the scrotum. Direct hernias often have wide necks and are much less likely to trap, obstruct or strangulate intestine than indirect hernias, whose necks are often narrow. Unfortunately, it is impossible reliably to distinguish a direct hernia from a small indirect hernia clinically.
Long-standing groin pain in an elite athlete: usefulness of ultrasound in differential diagnosis and patient education – a case report
Published in European Journal of Physiotherapy, 2018
Kingsley S. R. Dhinakar, Anjanette Cantoria Lacaste
There are four defined clinical entities for groin pain described in Doha agreement. Adductor-related groin pain presents with adductor tenderness and pain on resisted adduction testing. Iliopsoas tenderness, pain on resisted hip flexion and/or pain on stretching the hip flexors are noted in iliopsoas-related groin pain. Inguinal-related groin pain presents with pain and tenderness in the inguinal canal, aggravated by resistance testing of abdominal muscles or on valsalva/cough/sneeze and with no palpable inguinal hernia. Tenderness of the pubic symphysis and adjacent bone with no particular resistance or provocation test are associated with pubic-related groin pain. Although DOHA agreement has defined clinical entities for groin pain, the exact physical examination was not being discussed and more than one clinical entity can be presented and instrumental diagnosis is not mandatory. Instrumental diagnosis can be often helpful as differential diagnosis needs multifactorial cause elimination. In addition, exploring the role of imaging in the prediction of treatment response or prognosis in those with groin pain is encouraged during the Doha agreement [5]. This information will enable better understanding of the clinical relevance and aid in diagnosis. There is consensus in the literature that groin pain and conjoint tendon laxity or loading variation are effectively diagnosed using ultrasound examination [13,14].
New mutation causing androgen insensitivity syndrome – a case report and review of literature
Published in Gynecological Endocrinology, 2019
Marzena Maciejewska-Jeske, Patrycja Rojewska-Madziala, Karolina Broda, Karolina Drabek, Anna Szeliga, Adam Czyzyk, Stanislaw Malinger, Anna Kostrzak, Agnieszka Podfigurna, Gregory Bala, Blazej Meczekalski, Agnieszka Malcher, Maciej Kurpisz
Recent discussions in the literature postulate that a diagnosis of AIS can be made prenatally in cases where a karyotype obtained from amniotic fluid contradicts sex-determining observations by ultrasonography. Most cases of CAIS, however, are unrecognized at birth and continue to go unnoticed throughout childhood due to the unambiguously female phenotype of the infant. On rare occasions when discovered in infancy, inguinal hernias or testes in the inguinal canals in a female patient are the first hint at the diagnosis [6]. Otherwise, screening for CAIS is difficult and often only considered when delayed puberty or primary amenorrhea is observed in adolescence [7,8].
Pattern of inguinal hernia in Al- Basra teaching hospital: a prospective clinical study
Published in Alexandria Journal of Medicine, 2021
In this study, male patients out-numbered female patients, the reason for the male predominance may be the inherent weakness of the abdominal wall where the spermatic cord passes through the inguinal canal, which consistent with the results of other studies [4–7]. We observed that 52 (20.8%) patients had a family history of inguinal hernia. Similar observations were reported in other studies such as those by Lau et al. and Junge et al. who also described a positive family history as an important predictor of inguinal hernia [8,9].