Groin_Hernias - Groin Hernias Vic V Vernenkar D.O St...

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Unformatted text preview: Groin Hernias Vic V. Vernenkar, D.O. St. Barnabas Hospital Bronx, NY Definition Abnormal protrusion of a peritoneal lined sac thru the musculoaponeurotic covering of the abdomen Introduction In US 96% are inguinal, 4% femoral 20% bilateral Most common in both sexes indirect. Femoral hernias more common in elderly females Male to female ratio in 9:1 for inguinal hernias, 1:3 for femoral hernias Anatomy 4cm in length 2-4 cm cephalad to inguinal ligament Extends between superficial and deep rings Contains spermatic cord or round ligament Anatomy Bounded superficially by external oblique Cephalad by internal oblique, TA, transversalis Inferior border is inguinal ligament Floor is transversalis fascia Layers Skin, subcutaneous, campers, scarpa, external oblique fascia, cremaster, spermatic cord, cremaster, transversus abdominis, transversalis fascia, preperitoneal tissues, peritoneum Anatomy Broadly classified as indirect and direct depending on relationship to epigastric vessels. Hesselbach’s triangle is inferior epigastric artery laterally, lateral border of rectus medially, inguinal ligament inferiorly. Anatomy An indirect hernia passes lateral to Hesselbach’s triangle. A direct hernia passes thru Hesselbach’s triangle. Indirect hernia has a congenital component, from processus vaginalis....
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Groin_Hernias - Groin Hernias Vic V Vernenkar D.O St...

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