Abstract
Background
There are few articles in the literature reporting the histological changes of groin structures affected by inguinal hernia. A deeper knowledge of this matter could represent an important step forward in the identification of the causes of hernia protrusion. This study aimed to recognise the pathological modifications of muscular structures in autopsy specimens excised from tissues surrounding the hernia orifice.
Methods
Inguinal hernia was identified in 30 autopsied cadavers, which presented different varieties of hernia, including indirect, direct and mixed. Tissue specimens were resected for histological study from structures of the inguinal area surrounding the hernia opening, following a standardised procedure. The histological examination was focussed on the detection of structural changes in the muscle tissues. The results were compared with biopsy specimens resected from corresponding sites of the inguinal region in a control group of 15 fresh cadavers without hernia.
Results
Significant modification of the muscular arrangement of the inguinal area was recognized. Pathological alterations such as atrophy, hyaline and fibrotic degeneration, as well as fatty dystrophy of the myocytes were detected. These findings were observed consistently in the context of multistructural damage also involving vessels and nerves. In cadavers with hernia these alterations were always present independent of hernia type. No comparable damage was found in control cadavers without hernia.
Conclusions
The high degree of degenerative changes in the muscle fibres in the inguinal area involved in hernia protrusion described in this report seems to be consistent with chronic compressive damage. These alterations could embody one important factor among the multifactorial sources of hernia genesis. Conjectures concerning its impact on the physiology and biodynamics of the inguinal region are made. The relationship between the depicted degenerative injuries and the genesis of inguinal hernia is also a focus of discussion in this article.
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References
Lytle WJ (1961) Anatomy and function in hernia repair. Proc R Soc Med 54:967–970
Stoppa R (1984–2004) Como se forma una hernia inguinal? Actualizacion en hirugia del aparato digestivo. Fundacion MMA 8:469–473
Flament JB (2006) Funktionelle Anatomie der Bauchwand. Chirurg 77:401–407
Read RC (2003) Recent advances in the repair of groin herniation. Curr Probl Surg 40(1):13–79
Peacock EE, Madden JW (1974) Studies on the biology and treatment of recurrent inguinal hernia II. Morphological changes. Ann Surg 179:567–571
Klinge U, Binnebösel M, Mertens PR (2006) Are collagens the culprits in the development of incisional and inguinal hernia disease? Hernia 10(6):472–477
Pans A (2002) Biochemical study of collagen in adult groin hernias. J Surg Res 95(2):107–113
Friedman DW, Friedman DW, Boyd CD, Norton P, Greco RS, Boyarsky AH, Mackenzie JW, Deak SB (1993) Increases in type III collagen gene expression and protein synthesis in patients with inguinal hernias. Ann Surg 218(6):754–760
Amato G, Sciacchitano T, Bell SG, Romano G, Cocchiara G, Lo Monte AI, Romano M (2009) Sphincter-like motion following mechanical dilation of the internal inguinal ring during indirect inguinal hernia procedure. Hernia 13:67–72
Amato G, Marasa L, Sciacchitano T, Bell SG, Romano G, Gioviale MC, Lo Monte AI, Romano M (2009) Histological findings of the internal inguinal ring in patients having indirect inguinal hernia. Hernia 13:259–262
Amato G, Ober E, Romano G, Salamone G, Agrusa A, Gulotta G, Bussani R (2011) Nerve degeneration in inguinal hernia specimens. Hernia 15:53–58
Amato G, Romano G, Salamone G, Agrusa A, Saladino VA, Silvestri F, Bussani R (2011) Damage to the vascular structures in inguinal hernia specimens. Hernia. doi:10.1007/s10029-011-0847-4
Klinge U, Binnebösel M, Mertens PR (2006) Are collagens the culprits in the development of incisional and inguinal hernia disease? Hernia 10(6):472–477
Pans A (2002) Biochemical study of collagen in adult groin hernias. J Surg Res 95(2):107–113
Friedman DW, Boyd CD, Norton P, Greco RS, Boyarsky AH, Mackenzie JW, Deak SB (1993) Increases in type III collagen gene expression and protein synthesis in patients with inguinal hernias. Ann Surg 218(6):754–760
Silvestri F, Bussani R (1990) Hypoxic right ventricular cardiomyopathy. A morphological and pathogenetic study on the myocardial atrophy and fatty infiltration. Pathologica 82:593–616
Basso C, Thiene G, Corrado D, Angelini A, Nava A, Valente M (1996) Arrhythmogenic right ventricular cardiomyopathy. Dysplasia, dystrophy, or myocarditis? Circulation 94(5):983–991
Bai YH, Takemitsu M, Atsuta Y, Takemitsu Y (1998) Pathology study of rabbit calf muscles after repeated compression. J Orthop Sci 3(4):209–215
Shoen FJ (2005) Blood vessels. In: Kumar V, Abbas AK, Fausto N (eds) Robbins and Cotran pathologic basis of disease. Saunders, Philadelphia, pp 513–515
Kincaid JC, Stewart JD (1999) Focal peripheral neuropathies. J Clin Neuromuscul Dis 1(2):113
Penkert G (1998) Nerve compression syndrome-1. Chirurg 69:1114–1122
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Amato, G., Agrusa, A., Romano, G. et al. Muscle degeneration in inguinal hernia specimens. Hernia 16, 327–331 (2012). https://doi.org/10.1007/s10029-011-0890-1
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DOI: https://doi.org/10.1007/s10029-011-0890-1