Successfully reported this slideshow.
DR SOUMITRA HALDER
DEPT. OF RADIO-
The inguinal ligament
The deep inguinal ring …
anatomic defect in the transversalis
The superficial inguinal ring….
defect in the external oblique
aponeurosis immediately superior
and lateral to the pubic tubercle.
--from the deep to the superficial inguinal
--3.75 cm long
--directed downwards and medially from
the deep to the superficial inguinal ring
spermatic cord (M )
Round ligament of ut ( F)
The inferior epigastric artery.
in areas of natural weakness
vessels penetrate the abdominal wall (femoral and spigelian)
fetal migration of testis, spermatic cord, or round ligament have
occurred (indirect inguinal)
broad flat weak tendons called aponeuroses (direct inguinal).
Why does hernia occurs ?
Right inguinal anatomy
1. Bubonocele.... The hernia is limited to the
2. Funicular.... The processus vaginalis is closed
just above the epididymis. The contents of the sac
can be felt separately from the testis, which lies
below the hernia.
3. Complete ( scrotal).... The testis appears to lie
within the lower part of the hernia.
Types of indirect inguinal hernia
Left, Image shows the right direct inguinal hernia sac lying posterior to the
spermatic cord (SC).
Right, Image shows the left indirect inguinal hernia sac lying anterior to the
spermatic cord (SC).
Spigelian fascia, the complex
aponeurotic tendon that lies
between the oblique muscles
laterally and the rectus
Femoral hernias arise within the femoral canal, which lies medial to the
common femoral vein just superior to the saphenofemoral junction and
inferior to the inguinal ligament.
31-year-old woman with femoral hernia. Sonogram of right inguinal
region parallel to and caudad to inguinal ligament corresponding to
transducer position 4.
Pre-Valsalva maneuver sonogram shows (hernia not visible) femoral
artery (A), femoral vein (V), and superior pubic ramus (curved
Post-Valsalva maneuver sonogram shows dilated femoral vein (V)
lateral to femoral hernia (arrows). Superior pubic ramus (curved
arrow) is also seen.
length 3-5 c.m.
width 2-4 c.m.
Prompt diagnosis is needed.
Enlarged to inf pole, only during standing
No dilatation on supine
Reflux only during Valsalva
Supine position also that increased in standing
Supine and even prone position
Reflux evident on rest
solid ± lobulation.
They don't have calcification nor tunica invasion.
Most seminomas demonstrate increased flow on color Doppler
irregular or ill-defined margins.
Echogenic foci within the substance of the tumors represent areas of
hemorrhage, calcification, or fibrosis.
They frequently have cystic components, consistent with regions of
Nonseminomatous germ-cell neoplasms
Abnormal collection of serous ﬂuid in
a part of the processus vaginalis, usually
High-resolution real-time sonography has a high degree of accuracy and
sensitivity in the detection, characterization, and localization of scrotal lesions,
making it the undisputed modality of choice for imaging the scrotum.
In the pediatric population, sonography is helpful in the diagnosis of
developmental abnormalities, epididymitis, testicular torsion, and testicular