APPLIED ANATOMY. 



The various kinds of hernia; due to developmental defects have been named as 

 follows : vaginal or congenitalfunicular, encysted, and infantile. 



Vaginal hernia into the processus vaginalis, commonly known as congenital hernia, 

 is where the vaginal process remains entirely open and the intestine passes down to 

 the testicle. In this form the testicle is found protruding into and at the bottom of 

 the hernial sac. Funicular Hernia. In this form the vaginal process is occluded 

 just above the testicle, but the funicular process above remains open and the intestine 

 descends into it. Encysted Hernia. Here the vaginal process is occluded at the 

 internal ring only, the remainder forming a continuous sac below containing the 

 testicle. When the intestine descends it pushes this septum, like the finger of a 

 glove, down into the cavity containing the testicle. In .operation, two serous layers 

 would be incised, within one of which is the testicle and within the other the 

 intestine. Infantile Hernia. In this form also the vaginal process is occluded only 

 at the internal ring. As the intestine descends it forms a sac posterior to the point 



Anterior superior 

 spine 



Aponeurosis of 

 external oblique 



Poupart's ligament 



External pillar of ring 

 Spermatic cord 



Sheath of rectus 



Linea semilunaris 



Intercolumnar fibres 

 External abdom- 

 inal ring 



Internal pillar 

 . of ring 



- Crest of pubis 

 Spine of pubis 



FIG. 395. Parts concerned in inguinal hernia; the external abdominal ring. 



of occlusion and vaginal process. Thus in operation three serous layers are cut 

 through in exposing the intestine and the sac is posterior to the testicle. 



Hydrocele. Hydrocele is an accumulation of fluid in the tunica vaginalis testis. 

 It is usually an acquired affection of adult life, and then does not appear to be 

 dependent on congenital anomalies. 



Encysted Hydrocele of the Cord. This consists of a cystic collection in the 

 course of the spermatic cord. It makes its appearance in infancy and childhood, 

 and is due to some portion of the funicular or vaginal process failing to become 

 obliterated. Serum accumulates in this unoccluded portion, forming a small serous 

 cyst. Sometimes a small opening furnishes a communication with the abdominal 

 cavity, forming a congenital hydrocelc. In this case the contents of the cyst can be 

 pressed back into the abdominal cavity only to reappear. Should the communicat- 

 ing opening become dilated by a descending coil of intestine, a hernia into the funi- 

 cular process would be the result. 



