Direct inguinal hernia
||It has been suggested that this article be merged with inguinal hernia. (Discuss) Proposed since January 2012.|
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The direct inguinal hernia, a type of inguinal hernia, enters through a weak point in the fascia of the abdominal wall, and its sac is noted to be medial to the inferior epigastric vessels. Direct inguinal hernias may occur in males or females, but males are ten times more likely to get a direct inguinal hernia.
A direct inguinal hernia protrudes through a weakened area in the transversalis fascia near the medial inguinal fossa within an anatomic region known as the inguinal or Hesselbach's triangle, an area defined by the edge of the rectus abdominis muscle, the inguinal ligament and the inferior epigastric artery. These hernias are capable of exiting via the superficial inguinal ring and are unable to extend into the scrotum.
When a patient suffers a simultaneous direct and indirect hernia on the same side, the result is called a "pantaloon" hernia (because it looks like a pair of pants, with the epigastric vessels in the crotch), and the defects can be repaired separately or together.
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 to individuals less susceptible to indirect hernias).  Additional risk factors include chronic constipation, overweight/obesity, chronic cough, family history and prior episodes of direct inguinal hernias.
- "Direct Inguinal Hernia". University of Connecticut. Retrieved May 6, 2012.
- James Harmon M.D. Lecture 13. Human Gross Anatomy. University of Minnesota. September 4, 2008.