A hernia in the groin area, more properly termed an
inguinal hernia, occurs when a a section of the peritoneum, or covering of the
intestines, bulges out through an opening or a tear in the fascia tissue of the external
oblique aponeurosis. A direct hernia may involve retroperitoneal fat being pushed
through the opening in the peritoneal sac, while in an indirect hernia a section of the
intestine is included in the sac. Indirect hernias can become trapped or strangulated, a
complication in which the fascia opening, also known as a fascia ring, pinches the
herniated material and cuts off the blood supply. A patient with a strangulated hernia
is at risk of gangrene.
A number of different hernia
classifications have been developed to describe the various locations and types of
hernias. The Nyhus classification is used commonly in the United States, and is
summarized on Medscape (see link) as follows:
Type 1 is an
indirect hernia with a normal internal ring of fascia
Type
2 is an indirect hernia with an enlarged internal ring of
fascia
Type 3a is a direct inguinal
hernia
Type 3b is an indirect hernia causing posterior wall
weakness
Type 3c is a femoral
hernia
Type 4 represents all recurrent
hernias
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