1101:(or hernia belt) is intended to contain a reducible inguinal hernia within the abdomen. It is not considered to provide a cure, and if the pads are hard and intrude into the hernia aperture they may cause scarring and enlargement of the aperture. In addition, most trusses with older designs are not able effectively to contain the hernia at all times, because their pads do not remain permanently in contact with the hernia. The more modern variety of truss is made with non-intrusive flat pads and comes with a guarantee to hold the hernia securely during all activities. They have been described by users as providing greater confidence and comfort when carrying out physically demanding tasks. However, their use is controversial, as data to determine whether they help prevent hernia complications are lacking. A truss also increases the probability of complications, which include strangulation of the hernia, atrophy of the spermatic cord, and atrophy of the fascial margins. This allows the defect to enlarge and makes subsequent repair more difficult. Their popularity is nonetheless likely to increase, as many individuals with small, painless hernias are now delaying hernia surgery due to the risk of
1155:, type of anesthesia (general or local), appropriateness of bilateral repair, etc. Mesh or non mesh repairs have both benefits in different areas, but mesh repairs may reduce the rate of hernia reappearance, visceral or neurovascular injuries, length of hospital stay and time to return to activities of daily living. Laparoscopy is most commonly used for non-emergency cases; however, a minimally invasive open repair may have a lower incidence of post-operative nausea and mesh associated pain. During surgery conducted under local anaesthesia, the patient will be asked to cough and strain during the procedure to help in demonstrating that the repair is without tension and sound.
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431:, might be one reason why men are 25 times more likely to have an inguinal hernia than women. Although several mechanisms such as strength of the posterior wall of the inguinal canal and shutter mechanisms compensating for raised intra-abdominal pressure prevent hernia formation in normal individuals, the exact importance of each factor is still under debate. The physiological school of thought thinks that the risk of hernia is due to a
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395:. Significant pain at the hernia site is suggestive of a more severe course, such as incarceration (the hernia cannot be reduced back into the abdomen) and subsequent ischemia and strangulation (when the hernia becomes deprived of blood supply). If the blood supply of the portion of the intestine caught in the hernia is compromised, the hernia is deemed "strangulated" and gut
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Hernias usually present as bulges in the groin area that can become more prominent when coughing, straining, or standing up. The bulge commonly disappears on lying down. Mild discomfort can develop over time. The inability to "reduce", or place the bulge back into the abdomen usually means the hernia
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Since the abdominal walls weaken with age, direct hernias tend to occur in the middle-aged and elderly. This is in contrast to indirect hernias which can occur at any age including the young, since their etiology includes a congenital component where the inguinal canal is left more patent (compared
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The deep inguinal ring, which is the beginning of the inguinal canal, remains as an opening in the fascia transversalis, which forms the fascial inner wall of the spermatic cord. When the opening is larger than necessary for passage of the spermatic cord, the stage is set for an indirect inguinal
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In 2015 inguinal, femoral and abdominal hernias affected about 18.5 million people. About 27% of males and 3% of females develop a groin hernia at some time in their life. Groin hernias occur most often before the age of one and after the age of fifty. Globally, inguinal, femoral and abdominal
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is still the most common groin hernia for females. If a woman has an indirect inguinal hernia, her internal inguinal ring is patent, which is abnormal for females. The protrusion of peritoneum is not called "processus vaginalis" in women, as this structure is related to the migration of the
281:, are absent in about a third of patients. Symptoms often get worse throughout the day and improve when lying down. A bulging area may occur that becomes larger when bearing down. Inguinal hernias occur more often on the right than left side. The main concern is strangulation, where the
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Complete (or scrotal): here the processus vaginalis is patent throughout. The hernial sac is continuous with the tunica vaginalis of the testis. The hernia descends down to the bottom of the scrotum and it is difficult to differentiate the testis from
45:
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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 through which the intestines may protrude.
1196:. However, if they experience discomfort while doing physical activities or they routinely avoid them for fear of pain, they should seek surgical evaluation. For female patients, surgery is recommended even for asymptomatic patients.
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Constipation after hernia repair results in strain to evacuate the bowel causing pain, and fear that the sutures may rupture. Opioid analgesia makes constipation worse. Promoting an easy bowel motion is important post-operatively.
991:, while inguinal hernias lie anteromedial to the cord and are not intramuscular. Large lipomas may appear nearly indistinguishable as the fat engulfs anatomic boundaries, but they do not change position with coughing or straining.
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to individuals less susceptible to indirect hernias). Additional risk factors include chronic constipation, being overweight or obese, chronic cough, family history and prior episodes of direct inguinal hernias.
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Emergency surgery for incarceration and strangulation carry much higher risk than planned, "elective" procedures. However, the risk of incarceration is low, evaluated at 0.2% per year. On the other hand,
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in 1789, affected by a major inguinal hernia since the age of 9 and whom his masters and bosses forced to perform hard labor in spite of it. He was hospitalized in 1867 and underwent a successful surgery.
850:
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1403:"Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015"
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1697:"Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015"
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Rosenberg J, Bisgaard T, Kehlet H, Wara P, Asmussen T, Juul P, et al. (February 2011). "Danish Hernia
Database recommendations for the management of inguinal and femoral hernia in adults".
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Rosenberg J, Bisgaard T, Kehlet H, Wara P, Asmussen T, Juul P, et al. (February 2011). "Danish Hernia
Database recommendations for the management of inguinal and femoral hernia in adults".
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Funicular: here the processus vaginalis is closed at its lower end just above the epididymis. The content of the hernial sac can be felt separately from the testis which lies below the hernia.
1746:"Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013"
907:
In an indirect inguinal hernia, the protrusion passes through the deep inguinal ring and is located lateral to the inferior epigastric artery. Hence, the conjoint tendon is not weakened.
2418:
Fitzgibbons RJ, Giobbie-Hurder A, Gibbs JO, Dunlop DD, Reda DJ, McCarthy M, et al. (18 January 2006). "Watchful
Waiting vs Repair of Inguinal Hernia in Minimally Symptomatic Men".
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occur medial to the inferior epigastric vessels when abdominal contents herniate through a weak spot in the fascia of the posterior wall of the inguinal canal, which is formed by the
888:. In normal development, the processus is obliterated once the testicle is completely descended. The permanent coat of peritoneum that remains around the testicle is called the
391:
As the hernia progresses, contents of the abdominal cavity, such as the intestines, can descend into the hernia and run the risk of being pinched within the hernia, causing an
332:
inheritance (especially for men). It is unclear if inguinal hernias are associated with heavy lifting. Hernias can often be diagnosed based on signs and symptoms. Occasionally
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because it resembles a pair of pants with the epigastric vessels in the crotch, and the defects can be repaired separately or together. Another term for pantaloon hernia is
420:
3215:
2101:
Burkhardt JH, Arshanskiy Y, Munson JL, Scholz FJ (March 2011). "Diagnosis of
Inguinal Region Hernias with Axial CT: The Lateral Crescent Sign and Other Key Findings".
435:
difference between patients who develop a hernia and those who do not, namely the presence of aponeurotic extensions from the transversus abdominis aponeurotic arch.
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Strangulated hernia: is one in which the blood supply of the hernia contents is cut off, thus, leading to ischemia. The lumen of the intestine may be patent or not.
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1143:. There are various surgical strategies which may be considered in the planning of inguinal hernia repair. These include the consideration of mesh use (e.g.
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Groin hernias that do not cause symptoms in males do not need to be repaired. Repair, however, is generally recommended in females due to the higher rate of
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There is currently no medical recommendation about how to manage an inguinal hernia condition in adults, due to the fact that, until the early 2010s,
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is the first choice of imaging, because it can both detect the hernia and evaluate its changes with for example pressure, standing and
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752:. Direct inguinal hernias may occur in males or females, but males are ten times more likely to get a direct inguinal hernia.
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testicle to the scrotum. It is simply a hernia sac. The eventual destination of the hernia contents for a woman is the
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A direct inguinal hernia is less common (~25â30% of inguinal hernias) and usually occurs in men over 40 years of age.
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600:
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Neutra R, Velez A, Ferrada R, Galan R (January 1981). "Risk of incarceration of inguinal hernia in Cali, Colombia".
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Irreducible/Incarcerated hernia: is one which cannot be pushed back into the abdomen by applying manual pressure.
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A frontal view of an incarcerated inguinal hernia (on the patient's left side) with dilated loops of bowel above.
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313:
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1503:"Whole-exome Sequencing Identifies a Potential TTN Mutation in a Multiplex Family With Inguinal Hernia - PubMed"
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2815:
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Stavros AT, Rapp C (September 2010). "Dynamic
Ultrasound of Hernias of the Groin and Anterior Abdominal Wall".
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1334:(22nd ed.). Philadelphia, Pa.: Wolters Kluwer Health/Lippincott Williams & Wilkins. p. 562.
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321:
232:
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Burcharth J, Pommergaard HC, Rosenberg J (2013). "The inheritance of groin hernia: a systematic review".
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3712:
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575:, lateral to the inferior epigastric vessels; this may be caused by failure of embryonic closure of the
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Simons MP, Aufenacker T, Bay-Nielsen M, Bouillot JL, Campanelli G, Conze J, et al. (August 2009).
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gives a coat to the testicle as it passes through this ring, forming a temporary connection called the
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on the same side, and hernias can enlarge one labium dramatically if they are allowed to progress.
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277:. Symptoms, which may include pain or discomfort especially with or following coughing, exercise, or
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Reducible hernia: is one which can be pushed back into the abdomen by putting manual pressure to it.
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Clinical classification of hernia is also important according to which hernia is classified into
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can result, with potentially fatal consequences. The timing of complications is not predictable.
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344:
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149:
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892:. The testicle remains connected to its blood vessels and the vas deferens, which make up the
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Simons MP, Aufenacker TJ, Berrevoet F, Bingener J, Bisgaard T, Bittner R, et al. (2017).
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1956:
James Harmon M.D. Lecture 13. Human Gross
Anatomy. University of Minnesota. September 4, 2008.
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Obstructed hernia: is one in which the lumen of the herniated part of intestine is obstructed.
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137:
1105:. Elasticated pants used by athletes may also provide useful support for the smaller hernia.
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2163:"European Hernia Society guidelines on the treatment of inguinal hernia in adult patients"
1648:"European Hernia Society guidelines on the treatment of inguinal hernia in adult patients"
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has passed through the deep inguinal ring. It is the most common cause of groin hernia. A
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Ultrasound image of inguinal hernia. Moving intestines in inguinal canal with respiration.
459:
443:
439:
333:
293:
222:
142:
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973:, the major differential in diagnosing indirect inguinal hernias is differentiation from
1552:"Association of Collagen Type I Alpha 1 Gene Polymorphism With Inguinal Hernia - PubMed"
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of the symptoms of inguinal hernia mainly includes the following potential conditions:
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1806:
1695:
GBD 2015 Disease and Injury
Incidence and Prevalence Collaborators (8 October 2016).
1501:
Mihailov E, Nikopensius T, Reigo A, Nikkolo C, Kals M, Aruaas K, et al. (2017).
1144:
1128:
1047:
980:, as both can contain only fat and extend along the inguinal canal into the scrotum.
673:
432:
343:(also a type of groin hernia) which have more complications. If strangulation occurs
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An inguinal hernia which contains part of the bladder. Bladder cancer also present.
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1980:
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and the inferior epigastric artery. These hernias are capable of exiting via the
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2636:
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987:, lipomas originate inferior or lateral to the cord, and are located inside the
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MRI of the same case (done for another purpose), also demonstrating fat content.
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180:
2658:
2006:
1550:
Sezer S, ĆimĆek N, Celik HT, Erden G, Ozturk G, DĂŒzgĂŒn AP, et al. (2014).
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Ultrasound of an indirect hernia containing fat, with testicle seen at right.
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Surgical correction is always recommended for inguinal hernias in children.
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1881:"SURPRISES IN HERNIAL SACSâDiagnosis of Tumors by Microscopic Examination"
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is blocked. This usually produces severe pain and tenderness of the area.
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3007:
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2140:. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
2114:
1744:
GBD 2013 Mortality and Causes of Death
Collaborators (17 December 2014).
1614:
1053:
870:
400:
396:
27:
Protrusion of abdominal contents through the inguinal canal in the pelvis
2563:
2367:
2319:
Lockhart K, Dunn D, Teo S, Ng JY, Dhillon M, Teo E, et al. (2018).
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Inguinal hernias, in turn, belong to groin hernias, which also includes
645:
Protrudes through the inguinal ring and is ultimately the result of the
427:, which transmitted the testicle and accommodates the structures of the
359:. Laparoscopic surgery generally has less pain following the procedure.
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3135:
3039:
3011:
1401:
GBD 2015 Mortality and Causes of Death
Collaborators (8 October 2016).
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1038:
977:
942:
A physician may diagnose an inguinal hernia, as well as the type, from
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517:
416:
301:
193:
57:
1830:"Surgical physiology of inguinal hernia repair - a study of 200 cases"
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3453:
3339:
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1192:(10-12%), and this is why males with minimal symptoms are advised to
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741:
540:
412:
266:
2237:
Purkayastha S, Chow A, Athanasiou T, Tekkis P, Darzi A (July 2008).
1131:. It is not recommended in minimally symptomatic hernias, for which
387:
Another frontal view of such a hernia, this time without pubic hair.
336:
is used to confirm the diagnosis or rule out other possible causes.
1646:
Simons MP, Aufenacker T, Bay-Nielsen M, et al. (August 2009).
1597:
Gong Y, Shao C, Sun Q, Chen B, Jiang Y, Guo C, et al. (1994).
411:
In males, indirect hernias follow the same route as the descending
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3015:
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Indirect
Inguinal Hernia - University of Connecticut Health Center
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A direct inguinal hernia protrudes through a weakened area in the
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522:
511:
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382:
371:
370:
155:
2475:"Overview of treatment for inguinal and femoral hernia in adults"
2136:
Klingensmith ME, Chen LE, Glasgow SC, Goers TA, Melby SJ (2008).
925:
In the female, groin hernias are only 4% as common as in males.
914:
Bubonocele: in this case the hernia is limited in inguinal canal.
622:
Enters through a weak point in the fascia of the abdominal wall (
2280:"Chronic postoperative pain: the case of inguinal herniorrhaphy"
2693:
904:
can be considered an incomplete obliteration of the processus.
740:
The direct inguinal hernia enters through a weak point in the
672:. A femoral hernia is not via the inguinal canal, but via the
363:
hernias resulted in 60,000 deaths in 2015 and 55,000 in 1990.
101:
2321:"Mesh versus non-mesh for inguinal and femoral hernia repair"
1171:
The photograph is blurry as the patient was shaking too much.
351:. Open surgery has the benefit of possibly being done under
112:
516:
An incarcerated inguinal hernia as seen on cross sectional
121:
118:
86:
1123:
Surgical incision in groin after inguinal hernia operation
1967:"Hernia: Treatment, Types, Symptoms (Pain) & Surgery"
1926:
1924:
1556:
Hernia: The Journal of Hernias and Abdominal Wall Surgery
1507:
Hernia: The Journal of Hernias and Abdominal Wall Surgery
95:
89:
83:
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and descend through the inguinal canal to the scrotum.
1452:"Etiology of Inguinal Hernias: A Comprehensive Review"
347:
is required. Repair may be done by open surgery or by
292:
Risk factors for the development of a hernia include:
865:
results from the failure of embryonic closure of the
115:
98:
92:
2553:
1599:"Genetic Study of Indirect Inguinal Hernia - PubMed"
1127:
Surgical correction of inguinal hernias is called a
380:
is 'incarcerated' which requires emergency surgery.
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2024:LeBlanc KE, LeBlanc LL, LeBlanc KA (15 June 2013).
763:within an anatomic region known as the inguinal or
571:occur when abdominal contents protrude through the
247:
239:
228:
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179:
171:
161:
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136:
109:
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68:
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900:hernia. The protrusion of peritoneum through the
786:When a patient develops a simultaneous direct and
421:development of the urinary and reproductive organs
555:, which are defined by their relationship to the
2413:
2411:
1169:(photo: United States Military Medical Archives)
724:Irreducible hernias are further classified into
1264:Fitzgibbons RJ J, Forse RA (19 February 2015).
328:causing predisposition to hernias seem to have
324:and they occur more often in certain families.
843:Ultrasound showing an indirect inguinal hernia
676:, which normally allows passage of the common
582:In the case of the female, the opening of the
2705:
787:
640:
568:
550:
320:, among others. Predisposition to hernias is
8:
2811:Esophagogastric junction outflow obstruction
2456:World guidelines for groin hernia management
2026:"Inguinal hernias: diagnosis and management"
1266:"Clinical practice. Groin hernias in adults"
706:, the content of the hernial sac contains a
1934:. University of Connecticut. Archived from
1396:
1394:
748:, and its sac is noted to be medial to the
617:
560:
544:
446:, however, some unusual contents may be an
375:Frontal view of an inguinal hernia (right).
208:, connective tissue disease, previous open
3831:
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2850:Esophageal intramural pseudodiverticulosis
2734:
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950:. For confirmation or in uncertain cases,
43:
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1720:
1671:
1622:
1526:
1477:
1467:
1450:Ăberg S, Andresen K, Rosenberg J (2017).
1426:
1323:
1321:
1319:
1317:
1259:
1257:
1255:
1253:
1251:
1249:
1247:
1245:
1243:
1241:
1239:
1237:
1235:
813:
687:, the content of the hernial sac is the
589:
2325:Cochrane Database of Systematic Reviews
1231:
468:
3078:Small intestinal bacterial overgrowth
869:. In the male it can occur after the
767:, an area defined by the edge of the
680:and vein from the pelvis to the leg.
298:chronic obstructive pulmonary disease
190:chronic obstructive pulmonary disease
7:
1162:Frank Lamb, a black slave born near
490:Different types of inguinal hernias.
2007:"UOTW #40 - Ultrasound of the Week"
1981:"UOTW #16 - Ultrasound of the Week"
1273:The New England Journal of Medicine
1139:. Surgery is commonly performed as
1097:used to be recommended. The hernia
478:Illustration of an inguinal hernia.
1331:The 5-minute clinical consult 2014
779:and are unable to extend into the
175:< 1 year old, > 50 years old
25:
3963:Spontaneous bacterial peritonitis
3810:Exocrine pancreatic insufficiency
2278:Aasvang E, Kehlet H (July 2005).
790:on the same side, it is called a
466:, and rarely malignant lesions.
3708:Secondary sclerosing cholangitis
2677:
2138:The Washington manual of surgery
1103:post-herniorrhaphy pain syndrome
965:or cross sectional imaging with
539:There are two types of inguinal
495:
483:
471:
438:Inguinal hernias mostly contain
76:
2949:Gastric antral vascular ectasia
2944:Portal hypertensive gastropathy
2821:Gastroesophageal reflux disease
1211:of inguinal hernia than women.
1137:post herniorraphy pain syndrome
1135:is advised, due to the risk of
875:double indirect inguinal hernia
3703:Primary sclerosing cholangitis
3553:Hepatic veno-occlusive disease
3375:Solitary rectal ulcer syndrome
2337:10.1002/14651858.CD011517.pub2
857:Incarcerated inguinal hernia
1:
3760:Sphincter of Oddi dysfunction
1762:10.1016/S0140-6736(14)61682-2
1713:10.1016/S0140-6736(16)31678-6
1419:10.1016/S0140-6736(16)31012-1
3669:Postcholecystectomy syndrome
3188:Intestinal pseudoobstruction
2796:Esophageal motility disorder
2069:10.1097/RUQ.0b013e3181f0b23f
1828:Desarda MP (16 April 2003).
1807:10.1016/0021-9681(81)90018-7
419:into the scrotum during the
1879:Yoell JH (September 1959).
1795:Journal of Chronic Diseases
1603:Journal of Medical Genetics
1207:Men have an 8 times higher
910:There are three main types
750:inferior epigastric vessels
649:failing to close after the
601:inferior epigastric vessels
557:inferior epigastric vessels
423:. The larger size of their
4021:
3654:Gallstone / Cholelithiasis
3178:Functional colonic disease
2974:ZollingerâEllison syndrome
1112:
653:during the embryonic stage
2855:Acute esophageal necrosis
2179:10.1007/s10029-009-0529-7
2030:American Family Physician
1664:10.1007/s10029-009-0529-7
1568:10.1007/s10029-013-1147-y
1519:10.1007/s10029-016-1491-9
1369:10.1007/s10029-013-1060-4
777:superficial inguinal ring
607:internal spermatic fascia
584:superficial inguinal ring
569:Indirect inguinal hernias
415:, which migrate from the
314:collagen vascular disease
243:27% (males), 3% (females)
206:collagen vascular disease
51:
42:
2954:Gastric dumping syndrome
2829:Laryngopharyngeal reflux
2816:Diffuse esophageal spasm
1932:"Direct Inguinal Hernia"
1469:10.3389/fsurg.2017.00052
927:Indirect inguinal hernia
863:indirect inguinal hernia
810:Indirect inguinal hernia
641:Indirect inguinal hernia
3570:Alcoholic liver disease
3103:Bile acid malabsorption
3047:Peptic (duodenal) ulcer
2500:Danish Medical Bulletin
1164:Halifax, North Carolina
1151:), open repair, use of
1115:Inguinal hernia surgery
952:medical ultrasonography
880:In the male fetus, the
769:rectus abdominis muscle
561:Direct inguinal hernias
3580:Hepatic encephalopathy
2964:Buried bumper syndrome
2895:Peptic (gastric) ulcer
2779:MalloryâWeiss syndrome
2722:human digestive system
2432:10.1001/jama.295.3.285
2391:UCSF Pediatric Surgery
2011:Ultrasound of the Week
1985:Ultrasound of the Week
1173:
1124:
1000:Differential diagnosis
995:Differential diagnosis
902:internal inguinal ring
858:
844:
830:
819:
736:Direct inguinal hernia
699:
618:Direct inguinal hernia
536:
528:
520:
393:intestinal obstruction
388:
376:
3805:Pancreatic pseudocyst
3674:Porcelain gallbladder
2786:Zenker's diverticulum
1847:10.1186/1471-2482-3-2
1285:10.1056/NEJMcp1404068
1161:
1122:
856:
842:
825:
817:
765:Hesselbach's triangle
761:medial inguinal fossa
708:Meckel's diverticulum
697:
534:
526:
515:
386:
374:
326:Deleterious mutations
273:contents through the
154:Pain, bulging in the
3609:Hepatorenal syndrome
3548:BuddâChiari syndrome
3505:Autoimmune hepatitis
3330:Intestinal adhesions
3088:Short bowel syndrome
2917:Functional dyspepsia
2835:Esophageal stricture
2801:Nutcracker esophagus
2686:at Wikimedia Commons
2115:10.1148/rg.312105129
2057:Ultrasound Quarterly
1707:(10053): 1545â1602.
1615:10.1136/jmg.31.3.187
1456:Frontiers in Surgery
1413:(10053): 1459â1544.
948:physical examination
757:transversalis fascia
565:transversalis fascia
349:laparoscopic surgery
316:, and previous open
64:view from the left).
3748:Choledocholithiasis
3619:Metabolic disorders
3585:Acute liver failure
3558:Portal hypertension
3510:Alcoholic hepatitis
3353:Radiation proctitis
3272:Mesenteric ischemia
3244:Gastroenterocolitis
3073:Blind loop syndrome
2883:Ménétrier's disease
2791:Barrett's esophagus
1885:California Medicine
1302:on 18 November 2021
886:processus vaginalis
662:Congenital / Adult
647:processus vaginalis
624:Hesselbach triangle
577:processus vaginalis
310:peritoneal dialysis
221:Based on symptoms,
202:peritoneal dialysis
3923:Undefined location
3914:GrynfelttâLesshaft
3815:Pancreatic fistula
3798:Pancreatic abscess
3753:Biliary dyskinesia
3724:Mirizzi's syndrome
3225:Large and/or small
2905:Dieulafoy's lesion
2774:Boerhaave syndrome
2628:External resources
2373:2007-09-27 at the
2297:10.1093/bja/aei019
1987:. 2 September 2014
1328:Domino FJ (2014).
1174:
1141:outpatient surgery
1125:
1077:Undescended testes
1017:Testicular torsion
867:deep inguinal ring
859:
845:
831:
820:
700:
651:testicle's passage
573:deep inguinal ring
537:
529:
521:
389:
377:
367:Signs and symptoms
357:general anesthesia
3987:
3986:
3983:
3982:
3823:
3822:
3425:
3424:
3282:Bowel obstruction
2984:
2983:
2682:Media related to
2668:
2667:
2534:"Inguinal hernia"
2387:"Inguinal Hernia"
2239:"Inguinal hernia"
2147:978-0-7817-7447-5
1938:on April 27, 2012
1341:978-1-4511-8850-9
1172:
1046:dilation, called
961:When assessed by
956:Valsalva maneuver
854:
840:
773:inguinal ligament
666:
665:
442:or a part of the
345:immediate surgery
255:
254:
217:Diagnostic method
60:inguinal hernia (
32:Medical condition
16:(Redirected from
4012:
4000:Inguinal hernias
3975:Pneumoperitoneum
3832:
3742:Common bile duct
3624:Wilson's disease
3614:Peliosis hepatis
3483:
3360:Proctalgia fugax
3267:Abdominal angina
3192:Ogilvie syndrome
3141:Pseudomembranous
2999:
2959:Gastric volvulus
2924:Pyloric stenosis
2735:
2720:Diseases of the
2714:
2707:
2700:
2691:
2681:
2555:
2544:
2543:
2530:
2524:
2523:
2495:
2489:
2488:
2486:
2485:
2479:www.uptodate.com
2470:
2464:
2463:
2461:
2450:
2444:
2443:
2415:
2406:
2405:
2403:
2402:
2393:. Archived from
2383:
2377:
2365:
2359:
2358:
2348:
2316:
2310:
2309:
2299:
2275:
2269:
2268:
2258:
2234:
2228:
2227:
2207:
2201:
2200:
2190:
2158:
2152:
2151:
2133:
2127:
2126:
2098:
2089:
2088:
2052:
2046:
2045:
2021:
2015:
2014:
2003:
1997:
1996:
1994:
1992:
1977:
1971:
1970:
1963:
1957:
1954:
1948:
1947:
1945:
1943:
1928:
1919:
1918:
1908:
1876:
1870:
1869:
1859:
1849:
1825:
1819:
1818:
1790:
1784:
1783:
1773:
1756:(9963): 117â71.
1741:
1735:
1734:
1724:
1692:
1686:
1685:
1675:
1643:
1637:
1636:
1626:
1594:
1588:
1587:
1547:
1541:
1540:
1530:
1498:
1492:
1491:
1481:
1471:
1447:
1441:
1440:
1430:
1398:
1389:
1388:
1352:
1346:
1345:
1325:
1312:
1311:
1309:
1307:
1301:
1295:. Archived from
1270:
1261:
1194:watchful waiting
1168:
1133:watchful waiting
1095:elective surgery
989:cremaster muscle
890:tunica vaginalis
855:
841:
800:Romberg's hernia
796:saddlebag hernia
792:pantaloon hernia
599:Relationship to
590:
499:
487:
475:
444:small intestines
353:local anesthesia
271:abdominal cavity
269:(protrusion) of
128:
127:
124:
123:
120:
117:
114:
111:
108:
104:
103:
100:
97:
94:
91:
88:
85:
82:
47:
35:
21:
4020:
4019:
4015:
4014:
4013:
4011:
4010:
4009:
3990:
3989:
3988:
3979:
3944:
3933:Internal hernia
3819:
3764:
3729:Biliary fistula
3687:
3678:
3664:Adenomyomatosis
3659:Cholesterolosis
3635:
3629:Hemochromatosis
3500:Viral hepatitis
3472:
3421:
3379:
3365:Rectal prolapse
3334:
3301:Fecal impaction
3291:Intussusception
3254:Crohn's disease
3220:
3203:Toxic megacolon
3115:
3113:Large intestine
3107:
3052:Curling's ulcer
3005:
3003:Small intestine
2992:
2980:
2888:Gastroenteritis
2859:
2724:
2718:
2684:Inguinal hernia
2669:
2664:
2663:
2623:
2622:
2566:
2552:
2547:
2532:
2531:
2527:
2497:
2496:
2492:
2483:
2481:
2472:
2471:
2467:
2459:
2452:
2451:
2447:
2417:
2416:
2409:
2400:
2398:
2385:
2384:
2380:
2375:Wayback Machine
2368:Inguinal Hernia
2366:
2362:
2331:(9): CD011517.
2318:
2317:
2313:
2277:
2276:
2272:
2236:
2235:
2231:
2209:
2208:
2204:
2160:
2159:
2155:
2148:
2135:
2134:
2130:
2100:
2099:
2092:
2054:
2053:
2049:
2023:
2022:
2018:
2013:. 9 March 2015.
2005:
2004:
2000:
1990:
1988:
1979:
1978:
1974:
1965:
1964:
1960:
1955:
1951:
1941:
1939:
1930:
1929:
1922:
1878:
1877:
1873:
1827:
1826:
1822:
1801:(11): 561â564.
1792:
1791:
1787:
1743:
1742:
1738:
1694:
1693:
1689:
1645:
1644:
1640:
1596:
1595:
1591:
1549:
1548:
1544:
1500:
1499:
1495:
1449:
1448:
1444:
1400:
1399:
1392:
1354:
1353:
1349:
1342:
1327:
1326:
1315:
1305:
1303:
1299:
1268:
1263:
1262:
1233:
1229:
1217:
1202:
1170:
1167:
1117:
1111:
1091:
1086:
997:
944:medical history
940:
938:Medical imaging
847:
833:
812:
788:indirect hernia
738:
704:Littre's hernia
685:Amyand's hernia
670:femoral hernias
510:
503:
502:Inguinal fossae
500:
491:
488:
479:
476:
460:urinary bladder
409:
407:Pathophysiology
369:
341:femoral hernias
334:medical imaging
285:to part of the
279:bowel movements
259:inguinal hernia
223:medical imaging
143:General surgery
132:
105:
79:
75:
38:Inguinal hernia
33:
28:
23:
22:
15:
12:
11:
5:
4018:
4016:
4008:
4007:
4002:
3992:
3991:
3985:
3984:
3981:
3980:
3978:
3977:
3972:
3970:Hemoperitoneum
3967:
3966:
3965:
3954:
3952:
3946:
3945:
3943:
3942:
3941:
3940:
3935:
3930:
3919:
3918:
3917:
3916:
3911:
3898:
3897:
3892:
3887:
3882:
3877:
3876:
3875:
3870:
3859:
3858:
3853:
3852:
3851:
3840:
3838:
3829:
3825:
3824:
3821:
3820:
3818:
3817:
3812:
3807:
3802:
3801:
3800:
3795:
3790:
3785:
3774:
3772:
3766:
3765:
3763:
3762:
3757:
3756:
3755:
3750:
3737:
3736:
3731:
3726:
3717:
3716:
3715:
3710:
3705:
3694:
3692:
3680:
3679:
3677:
3676:
3671:
3666:
3661:
3656:
3651:
3645:
3643:
3637:
3636:
3634:
3633:
3632:
3631:
3626:
3616:
3611:
3606:
3605:
3604:
3599:
3589:
3588:
3587:
3582:
3572:
3567:
3566:
3565:
3560:
3555:
3550:
3538:
3537:
3536:
3526:
3525:
3524:
3514:
3513:
3512:
3507:
3502:
3491:
3489:
3480:
3474:
3473:
3471:
3470:
3469:
3468:
3458:
3457:
3456:
3451:
3441:
3439:Blood in stool
3435:
3433:
3427:
3426:
3423:
3422:
3420:
3419:
3414:
3412:Anal dysplasia
3409:
3404:
3399:
3389:
3387:
3381:
3380:
3378:
3377:
3372:
3367:
3362:
3357:
3356:
3355:
3344:
3342:
3336:
3335:
3333:
3332:
3327:
3326:
3325:
3315:
3314:
3313:
3303:
3298:
3293:
3288:
3279:
3277:Angiodysplasia
3274:
3269:
3258:
3257:
3256:
3246:
3241:
3240:
3239:
3228:
3226:
3222:
3221:
3219:
3218:
3212:Diverticulosis
3208:Diverticulitis
3205:
3196:
3195:
3194:
3185:
3175:
3170:
3169:
3168:
3163:
3158:
3153:
3148:
3143:
3133:
3127:
3125:
3109:
3108:
3106:
3105:
3100:
3098:Milroy disease
3095:
3090:
3085:
3080:
3075:
3070:
3068:Tropical sprue
3065:
3056:
3055:
3054:
3044:
3043:
3042:
3037:
3032:
3021:
3019:
2996:
2990:Lower GI tract
2986:
2985:
2982:
2981:
2979:
2978:
2977:
2976:
2966:
2961:
2956:
2951:
2946:
2941:
2936:
2931:
2926:
2921:
2920:
2919:
2909:
2908:
2907:
2902:
2892:
2891:
2890:
2885:
2880:
2869:
2867:
2861:
2860:
2858:
2857:
2852:
2847:
2842:
2837:
2832:
2826:
2825:
2824:
2818:
2813:
2808:
2803:
2793:
2788:
2783:
2782:
2781:
2776:
2766:
2765:
2764:
2759:
2754:
2743:
2741:
2732:
2730:Upper GI tract
2726:
2725:
2719:
2717:
2716:
2709:
2702:
2694:
2688:
2687:
2675:
2666:
2665:
2662:
2661:
2644:
2632:
2631:
2629:
2625:
2624:
2621:
2620:
2609:
2598:
2583:
2567:
2562:
2561:
2559:
2558:Classification
2551:
2550:External links
2548:
2546:
2545:
2525:
2490:
2465:
2445:
2407:
2378:
2360:
2311:
2270:
2229:
2202:
2173:(4): 343â403.
2153:
2146:
2128:
2090:
2063:(3): 135â169.
2047:
2016:
1998:
1972:
1958:
1949:
1920:
1891:(3): 146â148.
1871:
1820:
1785:
1736:
1687:
1658:(4): 343â403.
1638:
1589:
1542:
1493:
1442:
1390:
1347:
1340:
1313:
1230:
1228:
1225:
1224:
1223:
1221:Birkett hernia
1216:
1213:
1201:
1198:
1188:has a risk of
1113:Main article:
1110:
1107:
1090:
1087:
1085:
1082:
1081:
1080:
1073:Cryptorchidism
1070:
1065:
1060:
1058:pseudoaneurysm
1050:
1044:Saphenous vein
1041:
1035:
1024:
1019:
1014:
1009:
1007:Femoral hernia
996:
993:
975:spermatic cord
939:
936:
923:
922:
918:
915:
894:spermatic cord
877:has two sacs.
811:
808:
746:abdominal wall
737:
734:
733:
732:
729:
722:
721:
718:
678:femoral artery
664:
663:
660:
657:
654:
643:
637:
636:
633:
630:
627:
620:
614:
613:
610:
603:
597:
594:
509:
506:
505:
504:
501:
494:
492:
489:
482:
480:
477:
470:
452:diverticulitis
429:spermatic cord
425:inguinal canal
408:
405:
368:
365:
275:inguinal canal
253:
252:
249:
245:
244:
241:
237:
236:
230:
226:
225:
219:
213:
212:
186:Family history
183:
177:
176:
173:
169:
168:
165:
159:
158:
152:
146:
145:
140:
134:
133:
131:
130:
72:
70:
66:
65:
52:Diagram of an
49:
48:
40:
39:
31:
26:
24:
18:Scrotal hernia
14:
13:
10:
9:
6:
4:
3:
2:
4017:
4006:
4003:
4001:
3998:
3997:
3995:
3976:
3973:
3971:
3968:
3964:
3961:
3960:
3959:
3956:
3955:
3953:
3951:
3947:
3939:
3936:
3934:
3931:
3929:
3926:
3925:
3924:
3921:
3920:
3915:
3912:
3910:
3907:
3906:
3905:
3904:
3900:
3899:
3896:
3893:
3891:
3888:
3886:
3883:
3881:
3878:
3874:
3871:
3869:
3866:
3865:
3864:
3861:
3860:
3857:
3854:
3850:
3847:
3846:
3845:
3844:Diaphragmatic
3842:
3841:
3839:
3837:
3833:
3830:
3826:
3816:
3813:
3811:
3808:
3806:
3803:
3799:
3796:
3794:
3791:
3789:
3786:
3784:
3781:
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3767:
3761:
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3727:
3725:
3721:
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3701:
3700:
3699:
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3675:
3672:
3670:
3667:
3665:
3662:
3660:
3657:
3655:
3652:
3650:
3649:Cholecystitis
3647:
3646:
3644:
3642:
3638:
3630:
3627:
3625:
3622:
3621:
3620:
3617:
3615:
3612:
3610:
3607:
3603:
3600:
3598:
3595:
3594:
3593:
3592:Liver abscess
3590:
3586:
3583:
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3578:
3577:
3576:
3575:Liver failure
3573:
3571:
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3564:
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3559:
3556:
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3259:
3255:
3252:
3251:
3250:
3247:
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3242:
3238:
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3234:
3233:
3232:Enterocolitis
3230:
3229:
3227:
3223:
3217:
3213:
3209:
3206:
3204:
3200:
3197:
3193:
3189:
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3086:
3084:
3081:
3079:
3076:
3074:
3071:
3069:
3066:
3064:
3060:
3059:Malabsorption
3057:
3053:
3050:
3049:
3048:
3045:
3041:
3038:
3036:
3033:
3031:
3028:
3027:
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3020:
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3009:
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3000:
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2987:
2975:
2972:
2971:
2970:
2967:
2965:
2962:
2960:
2957:
2955:
2952:
2950:
2947:
2945:
2942:
2940:
2937:
2935:
2934:Gastroparesis
2932:
2930:
2927:
2925:
2922:
2918:
2915:
2914:
2913:
2910:
2906:
2903:
2901:
2900:Cushing ulcer
2898:
2897:
2896:
2893:
2889:
2886:
2884:
2881:
2879:
2876:
2875:
2874:
2871:
2870:
2868:
2866:
2862:
2856:
2853:
2851:
2848:
2846:
2845:Megaesophagus
2843:
2841:
2838:
2836:
2833:
2830:
2827:
2822:
2819:
2817:
2814:
2812:
2809:
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2696:
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2674:
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2657:
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2542:. 2017-08-11.
2541:
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2526:
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2505:
2501:
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2491:
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2476:
2469:
2466:
2458:
2457:
2449:
2446:
2441:
2437:
2433:
2429:
2426:(3): 285â92.
2425:
2421:
2414:
2412:
2408:
2397:on 2020-10-26
2396:
2392:
2388:
2382:
2379:
2376:
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2289:
2285:
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2274:
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2266:
2262:
2257:
2252:
2248:
2244:
2243:BMJ Clin Evid
2240:
2233:
2230:
2225:
2221:
2217:
2213:
2206:
2203:
2198:
2194:
2189:
2184:
2180:
2176:
2172:
2168:
2164:
2157:
2154:
2149:
2143:
2139:
2132:
2129:
2124:
2120:
2116:
2112:
2109:(2): E1âE12.
2108:
2104:
2103:RadioGraphics
2097:
2095:
2091:
2086:
2082:
2078:
2074:
2070:
2066:
2062:
2058:
2051:
2048:
2043:
2039:
2036:(12): 844â8.
2035:
2031:
2027:
2020:
2017:
2012:
2008:
2002:
1999:
1986:
1982:
1976:
1973:
1968:
1962:
1959:
1953:
1950:
1937:
1933:
1927:
1925:
1921:
1916:
1912:
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1661:
1657:
1653:
1649:
1642:
1639:
1634:
1630:
1625:
1620:
1616:
1612:
1609:(3): 187â92.
1608:
1604:
1600:
1593:
1590:
1585:
1581:
1577:
1573:
1569:
1565:
1562:(4): 507â12.
1561:
1557:
1553:
1546:
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1538:
1534:
1529:
1524:
1520:
1516:
1513:(1): 95â100.
1512:
1508:
1504:
1497:
1494:
1489:
1485:
1480:
1475:
1470:
1465:
1461:
1457:
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1438:
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1333:
1332:
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1318:
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1294:
1290:
1286:
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1279:(8): 756â63.
1278:
1274:
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1191:
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1181:
1178:
1165:
1160:
1156:
1154:
1150:
1146:
1142:
1138:
1134:
1130:
1129:hernia repair
1121:
1116:
1108:
1106:
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1083:
1078:
1074:
1071:
1069:
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1061:
1059:
1055:
1051:
1049:
1048:Saphena varix
1045:
1042:
1040:
1036:
1033:
1029:
1025:
1023:
1020:
1018:
1015:
1013:
1010:
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1003:
1001:
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992:
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949:
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928:
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913:
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897:
895:
891:
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883:
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876:
872:
868:
864:
828:
824:
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809:
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797:
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789:
784:
782:
778:
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766:
762:
758:
753:
751:
747:
743:
735:
730:
727:
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725:
719:
716:
715:
714:
711:
709:
705:
696:
692:
690:
686:
681:
679:
675:
674:femoral canal
671:
661:
658:
655:
652:
648:
644:
642:
639:
638:
634:
631:
628:
625:
621:
619:
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604:
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588:
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580:
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566:
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558:
554:
553:
548:
547:
542:
533:
525:
519:
514:
507:
498:
493:
486:
481:
474:
469:
467:
465:
461:
457:
453:
449:
445:
441:
436:
434:
433:physiological
430:
426:
422:
418:
414:
406:
404:
402:
398:
394:
385:
381:
373:
366:
364:
360:
358:
354:
350:
346:
342:
337:
335:
331:
327:
323:
319:
315:
311:
307:
303:
299:
295:
290:
288:
284:
280:
276:
272:
268:
264:
260:
251:59,800 (2015)
250:
246:
242:
238:
234:
231:
227:
224:
220:
218:
214:
211:
207:
203:
199:
195:
191:
187:
184:
182:
178:
174:
170:
167:Strangulation
166:
164:
163:Complications
160:
157:
153:
151:
147:
144:
141:
139:
135:
126:
74:
73:
71:
69:Pronunciation
67:
63:
59:
55:
50:
46:
41:
36:
30:
19:
3922:
3901:
3862:
3778:Pancreatitis
3740:
3690:biliary tree
3563:Nutmeg liver
3540:
3466:Hematochezia
3417:Pruritus ani
3402:Anal abscess
3397:Anal fistula
3393:Anal fissure
3306:Constipation
3260:
3131:Appendicitis
2939:Gastroptosis
2929:Achlorhydria
2768:
2757:Eosinophilic
2646:
2635:
2611:
2600:
2585:
2570:
2537:
2528:
2506:(2): C4243.
2503:
2499:
2493:
2482:. Retrieved
2478:
2468:
2455:
2448:
2423:
2419:
2399:. Retrieved
2395:the original
2390:
2381:
2363:
2328:
2324:
2314:
2290:(1): 69â76.
2287:
2284:Br J Anaesth
2283:
2273:
2246:
2242:
2232:
2218:(2): C4243.
2215:
2212:Dan Med Bull
2211:
2205:
2170:
2166:
2156:
2137:
2131:
2106:
2102:
2060:
2056:
2050:
2033:
2029:
2019:
2010:
2001:
1989:. Retrieved
1984:
1975:
1961:
1952:
1940:. Retrieved
1936:the original
1888:
1884:
1874:
1837:
1833:
1823:
1798:
1794:
1788:
1753:
1749:
1739:
1704:
1700:
1690:
1655:
1651:
1641:
1606:
1602:
1592:
1559:
1555:
1545:
1510:
1506:
1496:
1459:
1455:
1445:
1410:
1406:
1363:(2): 183â9.
1360:
1356:
1350:
1330:
1304:. Retrieved
1297:the original
1276:
1272:
1206:
1203:
1200:Epidemiology
1190:inguinodynia
1182:
1179:
1175:
1126:
1092:
1089:Conservative
1012:Epididymitis
998:
982:
960:
941:
932:labium majus
926:
924:
909:
906:
898:
879:
874:
862:
860:
804:
799:
795:
791:
785:
754:
739:
723:
712:
701:
682:
667:
612:Usual onset
581:
551:
545:
538:
456:colon cancer
448:appendicitis
437:
410:
390:
378:
361:
355:rather than
338:
318:appendectomy
291:
283:blood supply
263:groin hernia
262:
258:
256:
233:Conservative
210:appendectomy
181:Risk factors
29:
3958:Peritonitis
3720:Cholestasis
3698:Cholangitis
3641:Gallbladder
3529:Fatty liver
3449:Hematemesis
3431:GI bleeding
3237:Necrotizing
3166:Lymphocytic
3161:Collagenous
3156:Microscopic
3093:Steatorrhea
2994:Enteropathy
2840:Inlet patch
2762:Herpetiform
2747:Esophagitis
2637:MedlinePlus
2539:Mayo Clinic
1834:BMC Surgery
1306:18 November
1153:laparoscopy
827:T2 weighted
605:Covered by
596:Description
440:the omentum
188:, smoking,
172:Usual onset
3994:Categories
3950:Peritoneal
3928:Incisional
3849:Congenital
3793:Hereditary
3770:Pancreatic
3734:Haemobilia
3407:Hemorrhoid
3385:Anal canal
3323:Infectious
3311:Functional
3146:Ulcerative
3030:Duodenitis
2969:Gastrinoma
2613:DiseasesDB
2484:2017-11-19
2473:Brooks D.
2401:2018-11-15
1227:References
1084:Management
1068:Varicocele
1032:Lymph node
1028:adenopathy
963:ultrasound
882:peritoneum
3938:Richter's
3895:Spigelian
3890:Obturator
3880:Umbilical
3713:Ascending
3684:Bile duct
3517:Cirrhosis
3495:Hepatitis
3478:Accessory
3348:Proctitis
3199:Megacolon
3173:Dysentery
3083:Whipple's
3035:Jejunitis
3025:Enteritis
2912:Dyspepsia
2873:Gastritis
2806:Achalasia
2739:Esophagus
2656:emerg/251
2648:eMedicine
2512:1603-9629
1897:0008-1264
1209:incidence
1145:synthetic
1063:Hydrocele
1052:Vascular
1034:Swelling)
1026:Inguinal
983:On axial
759:near the
508:Diagnosis
306:pregnancy
287:intestine
240:Frequency
235:, surgery
229:Treatment
198:pregnancy
138:Specialty
3868:Indirect
3863:Inguinal
3597:Pyogenic
3542:Vascular
3318:Diarrhea
3296:Volvulus
3262:Vascular
3201: /
3190: /
3151:Ischemic
3118:Appendix
3008:Duodenum
2878:Atrophic
2752:Candidal
2659:ped/2559
2653:med/2703
2520:21299930
2440:16418463
2371:Archived
2355:30209805
2306:15531621
2265:19445744
2224:21299930
2197:19636493
2123:21415178
2085:31835133
2077:20823750
2042:23939566
1915:13846556
1866:12697071
1840:(1): 2.
1780:25530442
1731:27733282
1682:19636493
1584:22999363
1576:23925543
1537:27115767
1488:29018803
1437:27733281
1385:27799467
1377:23423330
1293:25693015
1215:See also
1149:biologic
1109:Surgical
1054:aneurysm
871:testicle
689:appendix
552:indirect
401:gangrene
397:ischemia
330:dominant
150:Symptoms
54:indirect
4005:Scrotum
3909:Petit's
3885:Femoral
3788:Chronic
3602:Amoebic
3370:Anismus
3136:Colitis
3063:Coeliac
3040:Ileitis
3012:Jejunum
2865:Stomach
2769:Rupture
2607:D006552
2346:6513260
2256:2908002
2188:2719730
1906:1577810
1815:7287860
1771:4340604
1722:5055577
1673:2719730
1633:8014965
1624:1049739
1528:5281683
1479:5614933
1428:5388903
1186:surgery
1039:abscess
1022:Lipomas
978:lipomas
921:hernia.
781:scrotum
744:of the
656:Lateral
518:CT scan
464:ovaries
417:abdomen
322:genetic
302:obesity
294:smoking
194:obesity
58:scrotal
3903:Lumbar
3873:Direct
3856:Hiatus
3836:Hernia
3688:Other
3454:Melena
3340:Rectum
2823:(GERD)
2642:000960
2518:
2510:
2438:
2353:
2343:
2304:
2263:
2253:
2222:
2195:
2185:
2167:Hernia
2144:
2121:
2083:
2075:
2040:
1991:27 May
1942:May 6,
1913:
1903:
1895:
1864:
1857:155644
1854:
1813:
1778:
1768:
1750:Lancet
1729:
1719:
1701:Lancet
1680:
1670:
1652:Hernia
1631:
1621:
1582:
1574:
1535:
1525:
1486:
1476:
1462:: 52.
1435:
1425:
1407:Lancet
1383:
1375:
1357:Hernia
1338:
1291:
1037:Groin
771:, the
742:fascia
635:Adult
629:Medial
546:direct
541:hernia
413:testes
267:hernia
248:Deaths
129:
62:median
3828:Other
3783:Acute
3534:MASLD
3487:Liver
3461:Lower
3444:Upper
3286:Ileus
3122:Colon
3016:Ileum
2831:(LPR)
2460:(PDF)
2081:S2CID
1580:S2CID
1381:S2CID
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