Inguinal canal and its multitude of contents: Pictorial review

Congress:

ECR 2020

Poster Number:

C-12968

Type:

Educational Exhibit

Keywords:

Abdominal Viscera, Anatomy, Emergency, Musculoskeletal soft tissue, CT, MR, Ultrasound, Abscess delineation, Complications, Normal variants, Abscess, Acute, Hernia, Not applicable, Performed at one institution

Authors:

N. Ramesh¹, N. El Saeity²; ¹Portlaoise/IE, ²Cheshire/UK

DOI:

10.26044/ecr2020/C-12968

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-12968

Fig. 2: Normal contents in the inguinal canal

Fig. 1: Anatomy of the inguinal canal

Fig. 3: Risk factors for hernia

Fig. 4: Classification of inguinal hernia

Learning objectives

The purpose of this educational poster is the present a pictorial review of the various usual and unusual contents seen in the inguinal canal

Background

Inguinal canal is a short narrow diagonal passage in the anterior lower abdominal wall. The canal measures approximately 4-5 cms in length, lined by aponeuroses of three muscles, the external oblique, internal oblique and transversus abdominis muscle line the inguinal canal with the inguinal ligament – the Poupart’s ligament lining the floor. Men have larger and a more prominent inguinal canal than women{ Figure 1} It has two openings at either end called the deep and superficial rings. The deep ring is an oval gap...

Findings and procedure details

Inguinal hernias may be congenital or acquired. Inguinal hernias classified depending on whether they are medial (direct) or lateral (indirect) to the inferior epigastric artery. Indirect hernias descend along the spermatic cord from deep to the superficial inguinal ring. Inguinal hernias can traditionally be diagnosed with physical clinical examinationØ However, radiological diagnosis is often necessary for: 1. Diagnosis of occult hernias 2. Identification of hernia contents as well as the choice of treatment 3. Complicated inguinal hernias Ultrasound is frequently the initial diagnostic modality of...

Conclusion

Reporting radiologist should be aware of the imaging features of the contents of the inguinal contents for early diagnosis, to guide the referring doctors and to reducing morbidity and mortality of patients Whilst inguinal hernias are mainly a clinical diagnosis, imaging plays an important role in diagnosing the different contents of the hernia or to exclude the presence of any mimics

Personal information and conflict of interest

N. Ramesh; Portlaoise/IE - Consultant at Midland Regional Hospital, Portlaoise, Ireland N. El Saeity; Cheshire/UK - Consultant at HSE No conflict of interest No financial sponsor

References

1. Diagnosis of Inguinal region hernias with Axial CT: The lateral crescent sign and other key findings. Burkhardt et al; Radiographics// https: doi.org/101148/rg.312105129 2.Sonography of inguinal region hernias: Jamadar D et al; American journal of Roentgenology 2006 187:1185-190 3.The inguinal and femoral canals: A practical step-by-step approach to accurate sonographic assessment; Yoong P et al; Indian J Radiol Imaging. 2013 Oct-Dec: 23 {4}: 391-395; doi: 10.4103/0971-2026.125586 4.Role imaging in the diagnosis of occult hernias: Miller et al: JAMA Surg.2014 Oct : 149{10}1077-80: doi: 10.1001/jamasurg.2014.484