Indirect vs Direct Hernia Inguinal Hernias Bimodal: < 1 and > 40 Direct: Protrudes directly through Hesselbach's triangle and medial to the inferior epigastric artery (IEA) Bulge ↓ upon reclining Indirect: Most common Protrudes through internal ring, lateral to IEA Medial to IEA: Direct; Lateral to IEA: Indirect (MDs dont LIe) Strangulation risk: indirect > direct Nonreducible hernia: emergent surgery consultation
Nepenthe /nɨˈpɛnθiː is a medicine for sorrow, literally an anti-depressant, a "drug of forgetfulness" mentioned in ancient Greek literature. "Erasing all sorrow.