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  Global Journal of Surgery 2012, 3: 11
  Research Article
Histology of the internal inguinal ring in patients with indirect inguinal hernia: An observational study
  Marcelo A. Beltrána,b, Carlos Barríac, Patricio A. Ayalab, Víctor J. Cortésa, Karina S. Crucesa  
a Department of Surgery – Hospital de La Serena, La Serena, Chile
b Medical School – Universidad Católica del Norte, La Serena, Chile
c Department of Patology – Hospital de La Serena, La Serena, Chile

  Introduction: The purpose of the present study was to investigate the basic histological structure of the internal inguinal ring in patients operated on for primary indirect inguinal hernia and describe those findings. Patients and Methods: A sample of 72 consecutive male patients older than 15 years-old with unilateral primary inguinal hernia submitted to elective surgery was studied. The primary outcome measure was the histological findings of the internal inguinal ring. Patients were divided in 3 groups according to age. Group I: patients between 15 and 40 years-old. Group II: patients between 41 and 70 years-old. Group III: patients older than 71 years-old. Results. All samples from the internal inguinal ring were constituted by fibrous fascial tissue with elastic fibers which were thicker in younger patients and thinner in older patients (p<0.0001). Adipose tissue between elastic fibers was absent in younger patients (p=0.003), and was present in older patients (p=0.001). Vascular sclerosis was minimum in group I, moderate in group II, and important in group III (p<0.0001). Acute or chronic inflammatory cells were absent in all patients. Conclusions: The basic histological characteristics of the internal inguinal ring in patients with indirect inguinal hernia consisted on reduced density and thickness of elastic fibers, and increased adipose tissue between elastic fibers, changes which were more notorious while the age of the patients increased. Vascular sclerosis was also more severe in older patients compared to younger patients. These histological changes were related to normal aging.
  Inguinal hernia; Indirect hernia;Internal inguinal ring; Hernia histology  

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