41. Inguinal Hernia
Location: Indirect occurs lateral to the inferior epigastric vessels, frequently descending into the scrotum. Direct occurs medial to these vessels, usually not reaching the scrotum. Cause: Indirect is usually due to a birth defect (persistent process vaginalis). Direct is acquired over time from weakened abdominal muscles and chronic pressure. Path: Indirect enters the deep inguinal ring, while direct pushes through the posterior wall of the inguinal canal.