Indirect Inguinal Hernia - Causes

Causes

A hernia occurs when intra-abdominal contents, commonly including preperitoneal fatty tissues, the peritoneum itself, and eventually omentum and intestines, traverse the ring to enter the inguinal canal. As time passes, the hernia contents may enlarge, extend the length of the canal, and even exit the canal through the external inguinal ring, an opening in the external oblique fascia, into the scrotum.

Failure of the processus vaginalis to close properly is very common in infants and will usually leave only a small hole through which abdominal fluid can pass from the abdomen into the scrotum. This is termed a communicating hydrocele and must be differentiated from a non-communicating hydrocele.

In a communicating hydrocele, the fluid collection will change in size from time to time as fluid may drain back and forth between abdominal cavity and scrotum and on examination there will be no way to "get over" the hydrocele when palpating. This is in contrast to a non-communicating hydrocele, which is a distinct entity that occurs when there is excess fluid formation within the scrotum for any number of reasons.