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The inguinal canal (IC) is an oblique triangular shape in the lower aponeurosis of the external obliquis muscle about 3-5 cm in length, it is superior and parallel to the inguinal ligament. Situated at the inferior part of the abdominal wall and extended medially and inferiorly.
Divided into the superficial and deep inguinal canal, becomes superficial as it passes from medial to lateral through penetrating the inguinal canal. It is a common site for herniation surrounded by 4 boundaries. If there is an increase in the intra-abdominal pressure forces the posterior wall to compress against the anterior wall seeking to strengthen it to avoid herniation.
Anterior wall: skin, superficial fascia, aponeurosis of external obliques, and part of the internal obliques muscle.
Posterior wall: the conjoint tendon ( the insertion point of the external and internal obliques muscles) most medial and transvesalis fascia lateral to it.
Roof/ superior wall: arching fibers of internal obliques and transversalis fascia.
Inferior wall: medial part of the inguinal ligament.
Deep/ lateral inguinal ring: located above the midpoint of the inguinal ligament, lateral to the epigastric vessels, it considered as a defect in the transversalis fascia developed at embryology and terminates superolateral to the pubic tubercle by the superficial ring. When there are an increase in the intra-abdominal pressure the IO muscle contracts making the canal taut.
Superficial inguinal ring: the end of the inguinal canal found 1 cm superolateral to the pubic tubercle, it is a defect in the aponeurosis of the external obliques, this ring surrounded medially by rectus abdominis it’s (inferolateral border), laterally by inferior epigastric vessel, and medial inguinal ligament inferiorly forming a triangle called inguinal triangle that is a landmark of the superficial ring.
- Ilioinguinal nerve, lymph, and blood vessels in both sex.
- Spermatic cord in the male
- Round ligament of the uterus in the female
- Direct hernia, protrusion of abdominal viscera through the posterior wall, it is acquired during adulthood.
- Indirect hernia, protrusion of abdominal viscera through the deep inguinal ring, the common type and represents about 50% and more liable to be congenital most common on the right side.
Inguinal endometriosis, in cases with inguinal canal stroma and ectopic endometrial glands.
Neoplasms, may develop from any structures of the canal.
varicosities of round Ligament in females, and varicoceles in males.
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