Regarding Femoral and Inguinal Hernias,
1. The indirect inguinal hernia is seen lateral to the inferior epigastric artery
2. The direct inguinal hernia has more potential for obstruction then indirect hernia
3. It is possible to classify the inguinal hernia based on ultrasound
4. Femoral hernias are seen in the posterolateral quadrant, when two perpendicular lines are drawn along the lateral edge of the pubic tubercle on the axial slices.
5. Coronal reformations are very useful in diagnosing incidental femoral hernias
Answers: T, F, F, T, T
Notes: The indirect inguinal hernia is seen lateral to the inferior epigastric artery and the direct is seen medial to it. The indirect inguinal hernia is congenital (failure of closure of internal inguinal ring) and the direct is secondary to weakness in the Hesselbach triangle. The indirect inguinal hernia is more prone for complication such as obstruction. Multislice CT is useful in identifying the inferior epigastric artery and helps in differentiating direct from indirect inguinal hernia. Two perpendicular lines are drawn along the lateral edge of the pubic tubercle. Femoral hernias lie in the posterolateral quadrant and the inguinal in the anterior half. Indirect are more medial and the direct or more lateral. Coronal reformations demonstrate "Radiological femoral triangle" which is normally fat filled and useful in demonstrating incidental hernias.
Reference: Cherian PT and Parnell AP. Diagnosis and Classification of inguinal and femoral hernia on multisection spiral CT. Clinical Radiology (2008) 63: 184-192
