Inguinal Canal

Original Editor - Khloud Shreif

Top Contributors - Khloud Shreif  

Introduction[edit | edit source]

Inguinal canal DIAGRAM.png

The inguinal canal (IC) is an oblique triangular shape in the lower aponeurosis of the external obliquis muscle about 3-5 cm in length, it is superior and parallel to the inguinal ligament. Situated at the inferior part of the abdominal wall and extended medially and inferiorly.

Divided into the superficial and deep inguinal canal, becomes superficial as it passes from medial to lateral through penetrating the inguinal canal. It is a common site for herniation surrounded by 4 boundaries. If there is an increase in the intra-abdominal pressure forces the posterior wall to compress against the anterior wall seeking to strengthen it to avoid herniation.

Boundaries[edit | edit source]

Anterior wall: skin, superficial fascia, aponeurosis of external obliques, and part of the internal obliques muscle.

Posterior wall: the conjoint tendon ( the insertion point of the external and internal obliques muscles) most medial and transvesalis fascia lateral to it.

Roof/ superior wall: arching fibers of internal obliques and transversalis fascia.

Inferior wall: medial part of the inguinal ligament[1].

[2]

Openings[edit | edit source]

Deep/ lateral inguinal ring: located above the midpoint of the inguinal ligament, lateral to the epigastric vessels, it considered as a defect in the transversalis fascia developed at embryology and terminates superolateral to the pubic tubercle by the superficial ring. When there are an increase in the intra-abdominal pressure the IO muscle contracts making the canal taut.

Superficial inguinal ring: the end of the inguinal canal found 1 cm superolateral to the pubic tubercle, it is a defect in the aponeurosis of the external obliques, this ring surrounded medially by rectus abdominis it's (inferolateral border), laterally by inferior epigastric vessel, and medial inguinal ligament inferiorly forming a triangle called inguinal triangle that is a landmark of the superficial ring.

Inguinal canal relations and contents

Contents[edit | edit source]

  • Ilioinguinal nerve, lymph, and blood vessels in both sex.
  • Spermatic cord in the male
  • Round ligament of the uterus in the female

Clinical Relevance[edit | edit source]

Inguinal hernia:

  • Direct hernia, protrusion of abdominal viscera through the posterior wall, it is acquired during adulthood.
  • Indirect hernia, protrusion of abdominal viscera through the deep inguinal ring, the common type and represents about 50% and more liable to be congenital most common on the right side.

Inguinal endometriosis, in cases with inguinal canal stroma and ectopic endometrial glands.

Neoplasms, may develop from any structures of the canal.

varicosities of round Ligament in females, and varicoceles in males[3].

Resources[edit | edit source]

ken Hub.

TeachMe Anatomy

References[edit | edit source]

  1. Caserta NM, Penachim TJ, Contardi EB, Barbosa RC, Gomes TL, Martins DL. Contents of the inguinal canal: identification by different imaging methods. Radiologia Brasileira. 2021 Feb 3;54:56-61.
  2. About Medicine. 3D Tour of the Inguinal Canal.Available from: http://www.youtube.com/watch?v=XrUGnE_qf3w[last accessed 3/8/2021]
  3. Revzin MV, Ersahin D, Israel GM, Kirsch JD, Mathur M, Bokhari J, Scoutt LM. US of the inguinal canal: comprehensive review of pathologic processes with CT and MR imaging correlation. Radiographics. 2016 Nov;36(7):2028-48.