Which type of hernia protrudes through Hesselbach's triangle?

• A. Direct inguinal
• B. Indirect inguinal
• C. Femoral
• D. Umbilical

Answer: (A)

Hesselbach's triangle marks a weak spot in the anterior abdominal wall where direct inguinal hernias occur. It is bounded medially by the rectus abdominis, inferiorly by the inguinal ligament, and laterally by the inferior epigastric vessels. A direct inguinal hernia pushes contents directly through the posterior wall of the inguinal canal into the region of this triangle, typically medial to the inferior epigastric vessels, usually due to a weakening of the abdominal wall from age or strain.

In contrast, indirect inguinal hernias pass lateral to the inferior epigastric vessels, through the deep inguinal ring, and often into the inguinal canal toward the scrotum because of a patent processus vaginalis. Femoral hernias go through the femoral canal below the inguinal ligament. Umbilical hernias occur at the umbilical ring in the midline.