Andrews B T, Burnand K G, Ferrar D
Department of Surgery, St Thomas' Hospital, London, UK.
J R Coll Surg Edinb. 1996 Apr;41(2):90-2.
The clinical distinction between direct and indirect inguinal hernias is often made by determining whether digital pressure over the deep inguinal ring is able to control the hernia. In 25 consecutive patients having inguinal hernia operations, the positions of the mid-inguinal point and the mid-point of the inguinal ligament were determined pre-operatively and compared with the position of the deep inguinal ring measured at operation. Neither the mid-inguinal point nor the mid-point of the inguinal ligament correctly predicted the position of the deep inguinal ring (the mean position of the deep inguinal ring was found to be 0.52 cm lateral to the mid-inguinal point and 0.46 cm medial to the mid-point of the inguinal ligament). If the position of the deep inguinal ring cannot be accurately determined using fixed landmarks, it is unlikely that direct and indirect inguinal hernias can be distinguished by clinical examination.
腹股沟直疝与斜疝的临床鉴别通常是通过确定按压腹股沟深环时能否控制疝块来进行。在连续25例接受腹股沟疝手术的患者中，术前确定腹股沟中点和腹股沟韧带中点的位置，并与手术中测量的腹股沟深环位置进行比较。腹股沟中点和腹股沟韧带中点均不能正确预测腹股沟深环的位置（发现腹股沟深环的平均位置在腹股沟中点外侧0.52 cm处，在腹股沟韧带中点内侧0.46 cm处）。如果使用固定标志不能准确确定腹股沟深环的位置，那么通过临床检查区分腹股沟直疝和斜疝的可能性不大。
