The herniographic appearance of direct inguinal hernias in adults.

Inguinal hernias can be demonstrated by positive contrast herniography in children and adults. In this latter age-group direct inguinal hernias are frequent and can appear with different location and shape. In this series of 39 inguinal hernias in 25 adults five different types could be distinguished, according to location. Lateral direct inguinal hernias were found protruding in an anterior direction from the medial inguinal fossa. Inguinofemoral hernias protruded in a mainly inferior direction from the medial inguinal fossa. Medial direct inguinal hernias protruded from the lateral region of the supravesical fossa just medial to the medial inguinal fold. Diverticular direct inguinal hernias were located in the medial aspect of the supravesical fossa. Supravesical inguinal hernias were located in the mid-line. The distinction between these direct hernias and their relation to and distinction from other hernias in the inguinal region is discussed.