Eighteenth-century specimen showing an inguinal hernia, located in the groin. The preparation shows a contraction within the hernia which resulted in necrosis of part of its contents.
DEFINITION: An inguinal hernia (pronounced /ˈɪŋɡwɨnəl ˈhɜrniə/) is a protrusion of abdominal-cavity contents through the inguinal canal. They are very common (lifetime risk 27% for men, 3% for women), and their repair is one of the most frequently performed surgical operations [today].
There are two types of inguinal hernia, direct and indirect, which are defined by their relationship to the inferior epigastric vessels. Direct inguinal hernias occur medial to the inferior epigastric vessels when abdominal contents herniate through the external inguinal ring. Indirect inguinal hernias occur when abdominal contents protrude through the deep inguinal ring, lateral to the inferior epigastric vessels; this may be caused by failure of embryonic closure of the processus vaginalis.
In the case of the female, the opening of the superficial inguinal ring is smaller than that of the male. As a result, the possibility for hernias through the inguinal canal in males is much greater because they have a larger opening and therefore a much weaker wall for the intestines to protrude through. [Wikipedia]
DESCRIPTION: ‘[T]he Patient must be laid on his Back, as aforementioned, and bound fast upon the place: then the Intestines being reduced, the Assistant shall retain them up with his hands, whilst the Operator maketh an oblique Mark in the Groin, to which place he thrusteth up the Testicle; then makes an Incision so deep and large upon it, as to take it out with the Spermatick Vessels, which he holdeth with the one hand, while the other he separates it from the Membranes. (In all which cases he must be careful not to lacerate them, for thereby he shall cause Convulsions, and hasten the death of the Patient.) That done, he maketh a Ligature above the Testicle upon the Vessels, and cuts it off. If there be fear of a flux of bloud, he cauterizeth the ends… then, re-placing them within the Belly, leaving the ends of the Ligature hanging out, he stitcheth up the Wound, dressing as above-said’. [Richard Wiseman, Eight Chirurgicall Treatises (1676), p. 154.]