Anatomical clinical aspect in the etiology of inguinal hernia

Abstract

Background. Decreased tone of the anterolateral abdominal wall muscles, actually is considered the main etiological factor in the appearance of inguinal hernia. Taking into consideration that the spinal nerves have the primary role in maintaining the muscle tone (in this case the lower thoracic nerves Th 5 - Th 12 and the ileoinginal and ileohypogastric nerves), it seems reasonable to go back and to study their origin, that is, to turn our attention to the intervertebral orifices, as their exit points from the spine, and to evaluate their function of innervating of paravertebral muscles. Objective of the study. Studying the correlation between the condition of paravertebral muscles, as a criterion that reflects the functionality of the spinal nerves and the appearance of inguinal hernia in children. Material and Methods. 25 patients, age 11-176 months, boys/girls ratio 1.5:1, hospitalized with the diagnosis of inguinal hernia. Data collected: disease history, life history (perinatal period, physiological and pathological history, hereditary-collateral history, etc), objective and physical examination of the patient, in addition intervertebral, lumbar and sacral region were photographed. Results. The hernia is diagnosed more frequently in male (60% vs 40%). The most affected age groups were 1-24 months and 50-74 months, and the least affected age group – 175-200 months. The surgery was performed at 0-24 months and 25- 49 months (28% and 24%, respectively), less frequently at 150- 200 months and 100-124 months. Conclusion. Taking into consideration those mentioned above, we can conclude that the pathology of the spinal nerves responsible for tone of antero-lateral abdominal wall muscle should not be underestimated as a predisposing factor in appearance of external abdominal hernias.