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
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 in the transversalis fascia, like 1 cm superior to the inguinal ligament and lateral to the inferior epigastric vessels, the superficial ring is a triangular opening in the aponeurosis of the external oblique muscle. The normal contents in the canal in male patients include the spermatic cord and in the females the round ligament {Figure 2}
The most common contents in the inguinal canal are fat and/or small or large bowel contents; the bowel contents can lead to features of bowel obstruction, an appendix in the inguinal can become inflamed and incarcerated {Amyand’s hernia- 1 %}. Other contents include stomach, Undescended testis, ovary, haematoma, seroma, abscess, varicocele, urinary bladder, primary and malignant lesions {metastatic or tumours of bowel} Ultrasound is the initial imaging choice with CT and MRI as the problem solving and for more specific evaluation and evaluation of complications. There are several lesions that mimic changes in the inguinal canal including femoral aneurysm, varicocele, varix, haematoma, skeletal changes {Exostosis, tumours, and callus formation} lymph nodes