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Histological findings in direct inguinal hernia

Investigating the histological changes of the herniated groin looking forward to ascertain the pathogenesis of hernia disease

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Abstract

Background

The study is focused on recognizing the histological changes of the structures close to and around the hernia opening in patients having direct inguinal hernia.

Methods

In 15 patients with primary bilateral direct inguinal hernia who underwent a Stoppa open posterior inguinal hernia repair, tissue specimens from the abdominal wall surrounding a direct hernia border were excised for histological examination. These findings in patients with direct inguinal hernia were compared with tissue specimens excised from the fossa inguinalis media of cadavers without hernia.

Results

Significant degenerative modifications such as fibrohyaline degeneration and fatty substitution of the muscle fibers were seen in the biopsy samples. Inflammatory infiltration with lympho-histiocitary elements, artery sub-occlusion and vascular congestion were also constantly identified. Noteworthy injuries of the nervous structures such as edema, degenerative fibrosis and atrophy were also detected. No comparable tissue damage was witnessed in the control samples.

Conclusion

Presence of inflammatory infiltration, vascular damage and regressive nerve lesions, as well as fibrohyaline degeneration and fatty dystrophy of the muscle fibers are the features seen within the examined structures surrounding the direct hernia opening. These findings could represent a reason for a structural and functional weakening of the inguinal region. Consequently, the described results lead the authors to depict these changes as a plausible cause of direct inguinal hernia protrusion.

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Acknowledgments

We thank Prof. Furio Silvestri and Prof. Rossana Bussani of the Anatomopathological Department of the University of Trieste (Italy) for the collaboration in purchasing the male cadavers without hernia for the control biopsy samples.

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Authors and Affiliations

  1. Department of General Surgery, Urgency and Organ Transplantation, University of Palermo, Via Rapisardi 66, 90144, Palermo, Italy

    G. Amato, A. Agrusa, G. Romano, G. Salamone, G. Cocorullo & G. Gulotta

  2. Department of Anesthesia and Intensive Care, University of Palermo, Palermo, Italy

    S. A. Mularo

  3. Department of Pathological Anatomy and Histology, University of Palermo, Palermo, Italy

    S. Marasa

Authors
  1. G. Amato
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  2. A. Agrusa
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  3. G. Romano
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  4. G. Salamone
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  5. G. Cocorullo
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  6. S. A. Mularo
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  7. S. Marasa
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  8. G. Gulotta
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Corresponding author

Correspondence to G. Amato.

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Amato, G., Agrusa, A., Romano, G. et al. Histological findings in direct inguinal hernia. Hernia 17, 757–763 (2013). https://doi.org/10.1007/s10029-012-1032-0

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  • DOI: https://doi.org/10.1007/s10029-012-1032-0

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