Why can an indirect hernia be controlled on physical examination yet a direct hernia cannot?

Can anyone explain to me the reason(s) as to why an indirect hernia can be controlled on physical examination yet a direct hernia cannot.

Apologies if it is obvious but I don't personally like rote memorisation.

Thank you :)

Authored By Muhammad Khan on Wednesday 27th February 2013

Responses

R Hutch
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Posted over 7 years ago

Indirect hernias protrude into the deep ring due to patent processus vaginalis. The deep ring lies lateral to the inferior epigastric vessels and this is where you occlude in your examination.
Direct hernia protrude through a defect/ weakness in

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Miss Luna Ibrahim
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Medical Student - Warwick
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Posted over 7 years ago

I think perhaps it is because as Dr Hutchinson says, in the normal examination scheme you would palpate for the deep ring, halfway along the inguinal ligament between the ASIS and the pubic tubercle and occlude here, thus preventing an indirect hernia

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