Indirect Hernia: Causes, Symptoms, Diagnosis, and Treatment

indirect hernia causes

It refers to a hernia caused by a birth (congenital) defect in the abdominal wall area.

An Inguinal Hernia is a condition that usually features contents of the abdomen (either fatty tissues or part of the small intestine) bulging through a spot in the abdominal wall.

While the cause for Direct Hernias is either an injury in the affected area or gradual weakening of the abdominal muscle walls, an Indirect Inguinal Hernia is the result of a defect that occurs at birth.

They’re the most common type of Inguinal Hernia, and they usually affect male children. Although, some cases of female infants could occur as well.

Such condition can lead to an incarcerated hernia when part of the fat or small intestine gets stuck in the groin or scrotum.

When an incarcerated hernia worsens, the blood supply to the small intestine gets obstructed, which causes “strangulation” of the small intestine and could result in the death (necrosis) of the strangulated section of this organ.

Cases of Indirect Hernias are likely to happen before the child reaches the age of 1 year.

Even though the origin of this health issue comes from the embryonic stages of human development, and most sufferers are children, it can occur at any point in a person’s life.


More often than not, an Indirect Inguinal Hernia occurs because of premature birth. The issue starts at the inguinal canal.

The inguinal canal is a short tubular conduit that extends inferiorly and medially through the inferior part of the abdominal wall.

During the development of an unborn child, the tissue that will become gonads (the primary reproductive organs) get formed in the posterior abdominal wall and descend through the abdominal cavity.

The inguinal canal starts fulfilling its function by serving as a pathway by which the spermatic cord, in the case of males, enters the scrotum.

In the case of females, the inguinal canal contains and transmits the round ligament of the uterus from the abdominal cavity.

The entrance of the abdominal lining, which extends into the inguinal canal, usually closes off a few weeks before or after birth.

In some cases, the lining of the abdomen does not close as it should, and that leaves an opening in the abdominal wall at the upper part of the inguinal canal.

When this entrance remains open, fat or part of the small intestines can protrude into the inguinal canal through this opening, and that’s how an Indirect Inguinal Hernia occurs.

In the case of females, their ovaries could slide into the inguinal canal causing an Indirect Hernia.

Symptoms of an Indirect Hernia

An Indirect Inguinal Hernia causes a protrusion that results in a bulge on either side of the groin.

Such bulge is the most noticeable symptom of this condition, and it becomes a lot easier to perceive when the patient is straining or coughing.

Another symptom is a sensation of pain and discomfort due to the protruded content sliding in and out of the abdomen into the inguinal canal, which the doctors can notice when the baby is crying.

In the case of baby boys, medical experts find a swollen or an enlarged scrotum.

Children may display other symptoms such as irritability and a remarkable lack of appetite.


A healthcare provider will likely perform a physical exam, some imaging tests such as x-rays, and look into the medical and family history to accurately diagnose the condition.

During a physical exam, medical experts usually examine the patient’s body looking for the bulge caused by a hernia.

They’ll likely try to evaluate the way it moves while seeing if they can massage the affected area back into its proper position in the abdomen.

Healthcare providers only use the imaging tests when trying to diagnose strangulation or incarceration, or in those cases when they can’t feel the herniated area through a physical exam.

Treatment of an Indirect Hernia

More often than not, medical experts recommend a surgical repair procedure to treat an Indirect Inguinal Hernia.

Hernia Surgery can prevent incarceration and strangulation, and it is usually a safe treatment for infants. Medical experts perform this procedure on an outpatient basis.

During the treatment, a surgeon will move the hernia sac away from the affected area and place the protruded content back into its proper position in the abdomen.

Doctors close the area with sutures. The recovery time for the patient tend to vary; it usually depends on the size of the protrusion, the age and overall health of the child, and the way the surgeon performed the procedure.