Direct Inguinal Hernia
These occur in the groin close to the indirect hernia but are different and are not due to the descent of the testicles. They are due to a weakness in the lower abdominal wall just above the groin. The connective tissue is thin and degenerates over time due to wear and tear, so they tend to occur in older patients. There is a genetic, inherited weakness of the connective tissue that contributes. Over time with the gradual degeneration of the tissue, heavy work and increased intra abdominal pressure the thin tissue weakens and allows a hernia to bulge through.
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They usually have a bigger opening and are less likely to get anything caught in them. So they are a little safer in the long term. However if left they can become large and are at risk of the same complications.
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Surgical repair can be similar to that of the Indirect inguinal hernia.
A 'direct hernia' seen from the inside of the tummy. No 1 is the hernia. No 2 is an artery. The hernia on the left of the artery defines it as direct. An indirect hernia would occur on the right of the artery No. 2