Muscle degeneration in inguinal hernia specimens

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.

Mannheim Peritonitis Index (MPI) and elderly population: prognostic evaluation in acute secondary peritonitis

“…It is well known the correlations between pharmacological strategies, such as in Crohn's disease, and the risk to develop rare tumors or complications such as bowel perforation. Bowel herniation also represents a risk factor of perforation (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37). Multiple Organ Failure (MOF) represents the fatal evolution of the peritonitis (4).…”

Neomyogenesis in 3D Dynamic Responsive Prosthesis for Inguinal Hernia Repair

“…In literature, this feature is thought to be related to the static nature of the flat meshes which, incorporated by motionless and rigid tissue elements, impede the regular muscle function of the repaired groin . Furthermore, recent studies concerning the pathogenesis of hernia disease have demonstrated the degenerative source of inguinal protrusions . This has generated new interest in the search for a more physiological and pathogenetic consequent repair concept of inguinal hernias.…”

Biologic Response of Inguinal Hernia Prosthetics: A Comparative Study of Conventional Static Meshes Versus 3D Dynamic Implants

“…As the inguinal region is one of the most motile areas of the body, it is surprising that all prosthetics used for hernia repair are static devices. Recent evidence indicates that inguinal hernia is a degenerative disease . Therefore, to repair abdominal wall defects, the goal of the employed therapy should be to regenerate typical abdominal wall tissue components.…”