IJAR.2024.163
Type of Article: Original Research
Volume 12; Issue 3 (September 2024)
Page No.: 9011-9016
DOI: https://dx.doi.org/10.16965/ijar.2024.163
Is Low Lying Pubic Tubercle A Risk Factor for Inguinal Hernia?
Deepika C. A *1, Harish Rao K 2.
*1 Assistant Professor, Department of General Surgery, Kasturba Medical College, Mangalore, Manipal academy of higher education, Manipal, Karnataka, India. ORCiD: 0000-0003-1847-9630
2 Professor, Department of General Surgery, Kasturba Medical College, Mangalore, Manipal academy of higher education, Manipal, Karnataka, India.
Corresponding Author: Dr. Deepika C. A, Assistant Professor, Department of General Surgery, Kasturba Medical College, Mangalore, Manipal academy of higher education, Manipal, Karnataka, India. E-Mail: drdeepikanayaka.ca@gmail.com
ABSTRACT:
Introduction: Inguinal hernia is the most common clinical entity that one comes across in surgical practice. According to recent research, the anatomical structure of the inguinal region is crucial for the development of hernias. Variations in the position of the pubic tubercle, especially a low-lying pubic tubercle, may alter the tension and integrity of the inguinal canal, potentially facilitating the development of hernias. This study compares the pubic tubercle locations in people with and without inguinal hernias by a thorough investigation of patient anatomical data and, to find any statistically significant associations which may help guide clinical practice and advance our knowledge of the pathophysiology of inguinal hernias.
Methods: A hospital-based case control study carried out from October 2018 to October 2022 for a period of 24 months. 70 individuals who met inclusion criteria were selected for each group. In supine position of patient, the measurements of the perpendicular distance between the inter-spinal line and the pubic tubercle (PT line) and the distance between two anterior superior iliac spines (AA line) were taken and evaluated in all patients along with height, weight, BMI and pelvic circumference. The PT distance of 7cm and more was considered as low lying pubic tubercle.
Results: Right sided inguinal hernia was found in 47.2 % of the cases. And most of them were indirect inguinal hernia (71.4%). Among the patients with hernia, the mean PT line distance was found significantly greater (7.807+/- 1.143) compared to the control group (6.60+/- 0.7846) with p value <0.0001. In our study, 71.4 % of patients with hernia had PT line >7 cm whereas in 81.4% of controls, the PT line was under 7 cm.
Conclusion: Pubic tubercle being low i.e. more than 7 cm of PT line could be the risk factor for development of inguinal hernia owing to the widening of Hasselbach’s triangle along with the alteration in the internal oblique muscle insertion resulting in less effective shutter mechanism.
Key words: Anterior superior iliac spine, Anthropological measurements Inguinal hernia, Low lying pubic tubercle, Risk factors.
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