Association of Low-lying Pubic Tubercle in Patients with Inguinal Hernia

Direct Diverticular Inguinal Hernia

Acta Radiologica ◽

10.1177/028418518802900112 ◽

1988 ◽

Vol 29 (1) ◽

pp. 57-60 ◽

Cited By ~ 2

Author(s):

O. Ekberg ◽

K. Kullenberg

Keyword(s):

Inguinal Hernia ◽

Physical Examination ◽

Clinical Presentation ◽

Clinical Manifestations ◽

Pubic Tubercle ◽

Radiographic Appearance

Nineteen patients with direct diverticular inguinal hernia (DDIH) were examined with herniography and surgically explored. A lump medially in the groin and pain were the prominent clinical manifestations in 18 patients. Physical examination indicated the presence of a DDIH in 6 patients. In 16 patients herniography revealed hernial sacs protruding from the supravesical fossa in 5 and from the medial inguinal fossa in 11. At operation a circumscribed defect was found in the transverse fascia laterally and cranially to the pubic tubercle in all patients. In 16 patients peritoneal hernial sacs were demonstrated at surgery while in 3 only lipomas (fatty hernia) were contained within the defect. In our opinion DDIH is a specific variety of inguinal hernia with a fairly typical clinical presentation and radiographic appearance but probably often overlooked at surgery.

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Role of low-lying pubic tubercle in the development of inguinal hernia

International Surgery Journal ◽

10.18203/2349-2902.isj20200284 ◽

2020 ◽

Vol 7 (2) ◽

pp. 389

Author(s):

Diwan Singh Jakhar ◽

Joginder Singh ◽

Ashok Kumar ◽

Dharmveer Jajra ◽

Sanjay Lodha

Keyword(s):

Inguinal Hernia ◽

Mean Value ◽

Oblique Muscle ◽

Pubic Tubercle ◽

Inclusion Criteria ◽

Medical College ◽

The Mean ◽

Internal Oblique ◽

Control Study

Background: Hernia is defined as abnormal protrusion of whole or a part of a viscus through the wall that contains it. Among all external abdominal hernias, inguinal hernia is one most commonly encountered. Many factors are responsible for the formation of the inguinal hernia but, what makes a few people more susceptible to this situation is still clearly not proved. The lowness of pubic tubercle is associated with narrow origin of internal oblique muscle from lateral inguinal ligament which fails to protect the deep inguinal ring consequently lead to inguinal hernia.Methods: The study was conducted in Sardar Patel Medical College and attached hospital, Bikaner for duration of 12 months from March 2018 to February 2019. It is a case-control study with 50 cases and 50 control meeting inclusion criteria. In all patients, following parameters SS line, ST line, height, weight was recorded and evaluated.Results: The mean value of ST line in our study group is 7.37±0.182 cm which is significantly greater (p=0.0001) than the controls the mean value being 7.01±0.262 cm. In our study, 98% of cases were having ST line >7.01 cm whereas 66% of controls were ST line under 7.01 cm.Conclusions: Group of people with low lying pubic tubercle are at high risk of developing inguinal hernia.

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The Role of Low-Lying Pubic Tubercle in the Development of Inguinal Hernia – A Control Study

International Journal of Medicine and Pharmacy ◽

10.15640/ijmp.v8n1a3 ◽

2020 ◽

Vol 8 (1) ◽

Author(s):

Dr. N. Juniorsundresh ◽

Dr. S. Narendran

Keyword(s):

Inguinal Hernia ◽

Pubic Tubercle ◽

Control Study

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The presence of a low lying pubic tubercle in patients with indirect inguinal hernia

International Surgery Journal ◽

10.18203/2349-2902.isj20181997 ◽

2018 ◽

Vol 5 (6) ◽

pp. 2074 ◽

Cited By ~ 1

Author(s):

Ashwin Aby Thomas ◽

Amrita Prasad ◽

D. S. A. Mahadevan

Keyword(s):

Inguinal Hernia ◽

Research Centre ◽

Indirect Inguinal Hernia ◽

Pubic Tubercle ◽

Protective Mechanisms ◽

Medical College ◽

Significant Difference ◽

Prostatic Enlargement ◽

Positive Correlations ◽

Surgery Department

Background: Among all external abdominal hernias, inguinal hernia is one most commonly encountered. Factors like chronic cough, constipation, prostatic enlargement etc. contribute to its development. Various defensive mechanisms of the inguinal canal like shutter and slit valve mechanisms help prevent its formation. In this study, a comparison has been made between the anthropometric measurements of the pelvis in patients with and without indirect inguinal hernia to look for a statistically significant difference in the position of the pubic tubercle which in turn affects the various protective mechanisms. Other measurements such as Height, Weight and interspinal distance have been included to look for positive correlations between the disease and said measurements.Methods: This study was conducted in the General Surgery Department of SRM Hospital, Medical College and Research Centre, Kattankulathur after ethics committee clearance. It is a case control study conducted on 140 consenting patients and meeting the inclusion criteria from March 2016 to August 2017, of which 70 each were patients of indirect inguinal hernia and patients without inguinal hernia.Results: Results developed using SPSS Software show majority of the subjects with a low lying pubic tubercle were inguinal hernia patients. There was also a positive correlation between the ratios of weight and ST length as well as Height and ST length between cases and controls.Conclusions: It can be concluded from this study that factors such as a low lying pubic tubercle and other related anthropometric variables predispose patients to develop indirect inguinal hernia.

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Do Infants and Children have Measurable Inguinal Canals?

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v33i3.8355 ◽

2013 ◽

Vol 33 (3) ◽

pp. 182-185 ◽

Cited By ~ 1

Author(s):

Roland I Osuoji ◽

Michael A Bankole

Keyword(s):

Early Childhood ◽

Inguinal Hernia ◽

Inguinal Canal ◽

Infants And Children ◽

Age Group ◽

Pubic Tubercle ◽

Common Procedure ◽

Premature Babies ◽

Deep Inguinal Ring

Introduction: Herniotomy is a common procedure performed by Paediatric Surgeons. However, opinions differ as to whether to open the inguinal canal when performing this procedure or not. Those who advocate performing herniotomy without opening the inguinal canal believe that in early childhood, the superficial inguinal ring is directly superimposed on the deep inguinal ring, there being no appreciable inguinal canal in this age group. Our study was planned to open the inguinal canal and simply measure the distance between the pubic tubercle medially and the inferior epigastric vessels laterally. Finding a measurable inguinal canal in all cases studies debunks the belief that the superficial inguinal ring frequently overlaps the deep inguinal ring. Materials and Methods: From October 2007 to September 2008 and from May 2012 to April 2013 the inguinal canals of 75 children from 1 day to 2 years old were measured during herniotomies and orchidopexies. Premature babies were excluded from this study. The inguinal canals were all opened. Using a simple sterilized metallic ruler, the distance between the ipsilateral inferior epigastric vessels and the ipsilateral pubic tubercle was measured. Results: The lengths of the inguinal canals ranged from 1cm to 4.5 cm (mean 2.88cm+/-.71cm SD). The shortest inguinal canal length was 1 cm while the longest inguinal canal was 4.5 cm. Conclusion: Children with inguinal hernia up to the age of 2 years have a measurable inguinal canal and we suggest the excision of the hearnial sac superficial to the external inguinal ring runs the risk of leaving substantial sac behind proximal to the transfixing suture, even when some traction is applied to the sac before applying the transfixing suture. DOI: http://dx.doi.org/10.3126/jnps.v33i3.8355 J. Nepal Paediatr. Soc. 2013;33(3):182-185

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