Difference between Direct vs Indirect Hernia
By Manav Sodhi +2 more
Medically reviewed by Dr. Nikita Toshi
Last updated: Feb 14, 2024Click to rate this article!
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By Manav Sodhi +2 more
Medically reviewed by Dr. Nikita Toshi
Last updated: Feb 14, 2024Table of Contents
An inguinal hernia can be categorised into two types: Direct and Indirect hernia. A direct hernia develops due to the weakening of the abdominal muscles and is most common in adult males. It is typically caused due to ageing, excess straining and stress.
Researchers have found that direct hernias in females are substantially less typical to occur. From my knowledge, this may be due to the uterus’s round ligament located within the inguinal canal, which may serve as a second barrier to the muscle. Additionally, in females, the inguinal canal is similarly smaller.
Dr. Siddharth Gupta, MD
Indirect inguinal hernia commonly develops in children due to a defect in the abdominal wall since birth. If an opening on the inguinal canal doesn’t get closed, there are chances that a part of the intestine or other developing organs can protrude, causing a hernia.
Did you know indirect inguinal hernias are common in infants and males? Researchers have found that up to 4% of all newborns, 2% of boy newborns, and 1% of girl infants are affected with indirect inguinal hernias. Your testicle starts above the lower abdominal wall, travels via the inguinal canal, and terminates in the scrotum. Since it is a pre-existing opening that is easily reopened, the area where your testicle passes through is more prone to hernias. Additionally, it may not be closed completely entirely during development.
Dr. Rajeev Singh, BAMS
| Different Factors | Direct Hernia | Indirect Hernia |
| Causes | > Ageing > Stress or strain > Previous surgery in the lower abdomen > Chronic coughing > Injury | > Heavy lifting > Constipation > Being overweight > Birth defect – When the inguinal canal opening fails to close completely by the time of birth |
| Symptoms | > Swollen lump > It may be felt in the abdominal wall and cannot descend into the scrotum > A bulge from the posterior wall of the inguinal canal > It is a circular, symmetric swelling at the external ring > Groin pain | > The bulge can descend through the scrotum > It passes through the inguinal canal > It appears as an elliptical swelling > The bulge is behind the fibres of the external muscle > Discomfort or pain while standing for too long. |
| Diagnosis | > Physical examination. The doctor will be able to identify a bulge in the groin as a hernia. > He/she may ask you to cough or strain while standing to examine the bulge properly > Imaging tests may be required, such as CT, Abdominal X-Ray and Ultrasound. | Imaging tests like: > Abdominal X-rays to take a picture. > Computerized tomography (CT) scan helps to see blood vessels and blood flow on the X-ray. > Ultrasound to get an image of your internal body organs. |
| Treatment options that can be advised by doctors | > Open surgery is done by making a large incision to place the hernia back in its place and repairing the abdominal wall with a mesh. > Laparoscopic surgery is done by making a few small incisions to insert a device and look inside the abdomen to treat the hernia. | > Open surgery > Laparoscopic surgery |
| Prevalence | > Common in older people, mostly above 40 years of age > It is a more common condition in males. | > It is usually seen in children, and young adults > Men are at a higher risk of developing this type of hernia than women |
| Complications | > If the hernia is trapped in the weak abdominal wall, it can obstruct bowel movements > Severe pain, nausea, vomiting > Inability to pass gas > The hernia bulge may turn dark in colour. | > Pressure on surrounding tissues due to enlargement of the hernia. > It can extend into the scrotum, causing pain and swelling. > Strangulated Hernia. This occurs when the blood flow to part of your intestine is cut off. It affects bowel tissue and can be a life-threatening condition which requires immediate surgery. |
Both direct and indirect inguinal hernias are very similar to each other, which is why you may confuse the symptoms of the two conditions. If you notice a lump around the abdomen, have groin pain and experience difficulty in passing stools or gas, book an appointment with a proctologist or general physician. He/she shall examine you, ask about your symptoms and tell you the difference between direct and indirect hernias. Appropriate treatment may be decided for your condition after a few diagnostic tests are done. Hernias have only one treatment option, which is surgery. There are no other alternative medicines, and leaving the conditions untreated for a long time may cause other complications. Never self-medicate and follow the doctor’s advice.
Also Read: Groin Pain When Walking: Understanding the Causes and Solutions
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