Direct inguinal hernias occur when weakened tissue in the inguinal triangle is compromised by physical exertion, causing intestinal tissue to breach the abdominal wall. Surgery is usually required to restore the tissue. Symptoms include a bulge, pressure, burning, and discomfort. Surgery repairs the tissue and may involve a mesh for reinforcement.
A direct inguinal hernia occurs when a weakened part of the inguinal triangle of Hesselbach is further compromised by excessive physical exertion forcing intestinal tissue to breach the abdominal wall and enter the inguinal canal. In some cases, a direct inguinal hernia can be life-threatening if the herniated tissue creates an intestinal obstruction or necrotizes. Direct inguinal hernias usually require surgery to restore the intestinal tissue to its anatomical position.
Generally, an inguinal hernia develops when excessive strain is placed on weakened tissue within the abdominal wall. If the physiology of the abdominal wall is compromised due to a congenital condition or age, physical exertion can cause the weakened tissue to tear or rupture. In the case of a direct inguinal hernia, intestinal tissue breaks through an impaired area of Hesselbach’s triangle, which includes a portion of the peritoneum, allowing it to enter the inguinal canal directly. Individuals who do a lot of heavy lifting or straining often develop a direct inguinal hernia. Other conditions that can contribute to the development of this serious condition include pregnancy, obesity and chronic constipation.
The onset of painful hernia symptoms generally requires a visit to the doctor. Diagnosing a direct inguinal hernia involves a complete physical and palpatory examination. Due to the obvious presentation that creates a hernial bulge, further testing is generally not needed.
In some cases, individuals may have an inguinal hernia but remain asymptomatic, meaning they do not experience recognizable signs or symptoms for some time. As the herniated tissue becomes more pronounced in the groin area, the individual may notice not only a telltale bulge, but feel sensations of pressure, burning, and discomfort in the affected area. It is not uncommon for the discomfort to intensify when bending over, coughing or straining during defecation. If the signs and symptoms of a direct inguinal hernia are ignored, the individual is at risk of complications, including hernial necrosis, a life-threatening condition that requires emergency surgery.
There is no way for a direct inguinal hernia to go away or heal on its own. Typically, if an individual remains asymptomatic, a wait-and-see approach is adopted. When symptoms cause significant discomfort, surgery is used to restore the herniated intestinal tissue to its anatomical position. Depending on the severity of your condition, laparoscopic or open surgery may be performed; the only difference between the two procedures is whether multiple small incisions or a single large incision are used to access the hernia.
During surgery to repair a direct inguinal hernia, the compromised intestinal tissue is returned to its normal position. The sutures repair the torn or broken abdominal tissue and close the hole. Generally, an additional mesh, made of synthetic or natural material, is placed over the weakened abdominal tissue as reinforcement to prevent future hernia development.
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