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At least 19 recordsLinked to original sources

[Case report: Ovarian torsion in inguinal canal].

Inguinal and scrotal hernias are two most common congenital anomalies observed by clinicians. The possibility of ovarian torsion following recurrent inguinal hernia is well known. Ultrasound examination of the inguinal region of a female infant showed a spherical, enlarged ovary with multiple tiny cysts. After the diagnosis of ovarian torsion, the patient underwent oopherectomy. It is possible to diagnose inguinal emergencies by high resolution ultrasonography.

Diagnosis, Differential↗

[A new method for plastic repair of the inguinal canal in treating inguinal hernias].

An analysis of the 20-years experience with treatment of inguinal hernias is presented. Patients with "light" forms of inguinal hernias and with a good condition of the posterior wall, inconsiderable widening of the deep opening of the inguinal canal can be successfully treated by Martynov's and Girard's methods. In complicated forms of the inguinal hernia it is necessary to strengthen the posterior wall of the inguinal canal, in cases with big recurrent and repeatedly recurring hernias it must be completely reconstructed, often with the help of alloplasty. A method of alloplasty of the inguinal canal is proposed for complicated forms of inguinal hernias. Operations were made on 62 patients, recurrent hernias were noted in 2 patients (3.4%). Another method of operations is proposed used in men of young and middle age excluding traumas of elements of the spermatic cord. Operations were performed on 111 patients, recurrences were noted in 2 of them (2%).

Adolescent↗

Schwannoma in the inguinal canal masquerading an inguinal hernia.

Benign neoplasms originating from the neuronal sheath are usually found along the distribution of the cranial nerves and in the flexor surfaces of the upper and lower extremities. We herein present a case of a 65-year-old man with a schwannoma located in the inguinal canal, which presented as an irreducible hernia. This is the first reported case in the English literature of a schwannoma with such a presentation.

Abdominal Neoplasms↗

[The 3-wall plastic repair of the inguinal canal in the surgical treatment of inguinal hernia].

The method of plasty of the inguinal canal consisting in strengthening of its inferior wall achieved by means of placement of the sutures embracing the inguinal ligament permitting to prevent the development of its disfibration dissection and rupture of the fibers is suggested. One hundred and forty-one operation was performed. The long-term results were studied at the period of from 2 to 10 years. Disease recurrence was noted in 1 (0.7%) patient.

Adult↗

Individual and associated effects of length of inguinal canal and caliber of the sac on clinical outcome in children.

PURPOSE: The caliber of processus vaginalis is accepted to define the clinical outcome to be an inguinal hernia or hydrocele not based on any evaluation. The caliber of sacs and length of inguinal canals of boys and girls were evaluated to define the relation of sex, age, and the diagnosis with caliber of the sac and the length of inguinal canal. METHODS: A total of 217 inguinal canals in 24 girls and 112 boys with inguinal hernia, 30 boys with hydrocele or hydrocele of the cord, and 31 boys with undescended testis have been evaluated. Twenty patients had bilateral involvement. The length of inguinal canal, and the circumference of the sac were measured. A formula was developed to predict the length of inguinal canal according to the age and sex. The circumferences of the sacs, length of inguinal canals, and the ratios of the circumference to the length were compared according to the clinical pictures. RESULTS: The regression model of the relationship between the age and the length of the inguinal canal is an equation of third degree (inguinal canal in millimeters) = 0.0000119 x age 3 (months) - 0.00292 x age 2 (months) + 0.3168 x age (months) + 19.979 (r2 = 0.47). Inguinal canal is longer in boys (25.133 and 27.996 mm; P = .018), and length does not differ among diagnoses but differs according to age showing a linear growth after 24 months. Although the circumference as a sole parameter could classify only 55.3% of boys correctly, the ratio of length of inguinal canal to circumference of the sac has been the significant parameter in classifying boys into 1 of 3 groups including inguinal hernia, undescended testis, and hydrocele with a 70.2% success rate. CONCLUSIONS: Inguinal canal that shows a linear growth after 24 months of age is longer in boys. Caliber is not the unique factor that determines the clinical outcome. Although the ratio of length of inguinal canal to the circumference of the sac defines the clinical picture best, even this parameter cannot classify the cases correctly. Therefore, some factors in addition to the caliber and length of inguinal canal might have roles in determining the clinical outcome.

Age Factors↗

Unusual findings in the inguinal canal: a report of four cases.

Masses in the inguinal canal other than hernias are rare occurrences, and their preoperative diagnosis requires a high index of suspicion. A soft, partly reducible groin mass in a 3-month-old boy proved to be a cystic lymphangioma within the inguinal canal. A 15-month-old female who presented with an irreducible inguinal mass was found to have a neuroblastoma metastasis in the groin. An irreducible groin mass in a 6-year-old female proved to be an inguinal canal epidermal inclusion cyst. A 14-year-old female presented with a painful groin swelling that represented an incarcerated hemorrhagic ovarian cyst. An awareness of the wide spectrum of entities other than the standard bowel, testicle, and ovary in the inguinal canal can help to identify uncommon pathologies preoperatively.

Adolescent↗

[The fascia of the inguinal canal ring].

The fascial anatomy of the inguinal canal has been investigated. The spermatic cord is fixed by two cords in addition to its embedding in connective tissue after leaving the inguinal canal. The spermatic cord has a special fastening in form of a noose at the deep inguinal ring. The transversalis fascia consists of an internal and an external leaf. A part of the internal leaf forms with three cords this noose and builds so a sphincter-like closure mechanism, which reduces the size of the deep inguinal ring by a local erection of the transversalis fascia. The internal leaf protects from an indirect inguinal hernia as well as from a direct inguinal hernia, because the wall of the so-called Hesselbach's triangle only consists of the internal leaf. A list of the anatomical synonyms is added.

Abdominal Muscles↗

The anatomic structure of the preperitoneal tissue (PPT) of the inguinal canal.

Anatomical examinations of the inguinal canal exist in many forms. The preperitoneal tissue, the structure directly adjacent to the transverse fascia, was examined in 62 cadavers. The left side of the inguinal abdominal wall was studied with special interest in the transverse fascia and the adjacent preperitoneal tissue. In 75% of the cases the transverse fascia and preperitoneal tissue built a continuous layer. A differentiation was difficult in cadavers with cachexia or an average nutritive state. The tissues could be differentiated without difficulty in individuals with adipositas. In these cases no connection between the two layers was detected. In the medial part of the inguinal abdominal wall the tissue thickness was larger than in the lateral part. However in 32% of the cases the tissue thickness was reverse. As a consequence, the isolated suture of the transverse fascia in inguinal hernia repair is anatomically virtually impossible, if both tissues build one continuous layer.

Adipose Tissue↗

Bilateral primary neuroblastomas in the inguinal canal.

The incidental finding of a nodular mass in the inguinal canal in children usually occurs during surgical exploration for an inguinal hernia. We report an unusual occurrence of neuroblastomas bilaterally and simultaneously in the inguinal canals of an infant with no evidence of metastatic disease.

Humans↗

Groin pain associated with ultrasound finding of inguinal canal posterior wall deficiency in Australian Rules footballers.

OBJECTIVES: To investigate the prevalence of inguinal canal posterior wall deficiency (sports hernia) in professional Australian Rules footballers using an ultrasound technique and correlate the results with the clinical symptom of groin pain. METHODS: Thirty five professional Australian footballers with and without groin pain were investigated blind with a dynamic high resolution ultrasound technique for presence of posterior wall deficiency. RESULTS: Fourteen players had a history of significant recent groin pain and ten of these were found to have bilateral inguinal canal posterior wall deficiency (p < 0.01). The relative risk for a history of groin pain with bilateral deficiency was 8.0 (95% confidence interval 1.73 to 37.1). Groin pain was also found to be associated with increasing age (p < 0.01) which was an independent risk factor. Surgical, clinical, and ultrasound follow up for players who underwent hernia repair confirmed the validity of ultrasound as a diagnostic tool. CONCLUSIONS: Dynamic ultrasound examination is able to detect inguinal canal posterior wall deficiency in young males with no clinical signs of hernia. This condition is very prevalent in professional Australian Rules footballers, including some who are asymptomatic. There was a correlation between bilateral deficiency and groin pain, although the temporal relationship between the clinical and ultrasound findings is not established by the current study. Ultrasound shows promise as a diagnostic tool in athletes with chronic groin pain who are considered possible candidates for hernia repair.

Adult↗

Clinical and anatomic features of the inguinal canal during hernia.

Seventy-eight patients affected by inguinal hernia, 33 by direct and 45 by indirect external oblique types, were studied. The morphologic and structural aspects of the inguinal canal including its length, the diameter of the deep inguinal ring and the qualitative features of the fascia transversalis and aponeuroses of the external and internal oblique muscles and of the transversus muscle were investigated. In all 78 patients with inguinal hernia, the length of the canal was 4.7 cm. In the 33 patients with direct inguinal hernia the width of the deep inguinal ring varied from 1.5 to 2.5. The aponeurosis of the external oblique muscle was dense in 19 cases (57.58%), rather laddered in 10 (30.30%) and very laddered in 4 (12.12%). The fascia transversalis was discontinued in 28 cases (84.85%) and velamentous in 5 cases (15.15%). In the 45 patients with indirect inguinal hernia the width of the deep inguinal ring varied from 1.5 to 7 cm. The aponeurosis of the external oblique muscle was dense in 14 cases (31.11%), rather laddered in 23 cases (51.11%), very laddered in 8 (17.78%). The fascia transversalis was dense in 15 (33.33%), elastic in 17 (37.78%) and velamentous in 13 cases (28.89%). Based on the results of this study, a series of therapeutic considerations are set forth. The most important of these include early surgical intervention, which is absolutely necessary, and the use of prostheses in the inguinal canal.

Adolescent↗

Inguinal canal "lipoma".

Groin dissection was performed in adult male post-mortem subjects to establish the prevalence of inguinal canal "lipoma." Thirty-six body halves (age range 24-92 years) were studied. Of these, 27 (75%) contained a discrete mass of fat within the inguinal canal. This mass was always continuous with the preperitoneal fat through the deep inguinal ring. Nineteen of these 27 masses (70%), displayed a characteristic pedunculated form with a bulbous distal end. Eighteen of the 36 dissections (50%), revealed a mass more than 4 cm in length. Six dissections showed extension of the mass beyond the superficial inguinal ring and three of these six (8% of the 36 groins studied) showed distortion of the proximal spermatic cord with a mass at the superficial inguinal ring. The masses submitted for histology comprised mature adipose tissue and all but two of these were reported as having an adherent capsule. No significant correlation was found between mass length and either subject age or body mass index (BMI) but a statistically significant correlation between the length of the fat mass on the left and right sides was shown. This study demonstrates that the inguinal canal "lipoma" is a common feature in an adult male population and may be of sufficient size to cause clinical misdiagnosis. The high prevalence, characteristic location and appearance of the "lipoma" suggest a developmental etiology.

Adipose Tissue↗