Inguinal canal development: The muscular wall and the role of the gubernaculum
✍ Scribed by Susana N. Biasutto; Emanuel Repetto; Mirta M. Aliendo; Valeria N. Borghino
- Publisher
- John Wiley and Sons
- Year
- 2009
- Tongue
- English
- Weight
- 263 KB
- Volume
- 22
- Category
- Article
- ISSN
- 0897-3806
- DOI
- 10.1002/ca.20820
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✦ Synopsis
Abstract
The inguinal canal is an anatomically complex region. Although much has been written about the gubernaculum and the descent of the testis, little is known about the development of the abdominal wall itself. We dissected this inguinal canal in 75 fetuses between 10 and 25 weeks of gestation, 42 males and 33 females. We identified the anterior body‐wall muscular layers, located the gonads and uterus, and observed the formation of the scrotum. The gubernaculum was dissected, from the deep to the superficial ends and its distal attachments were determined. We proved that the muscular‐fibrous layers of the wall were well‐differentiated and observed how the inguinal canal enlarged with embryological development. In only one of the cases, an abnormal testis was found located in the scrotum. The upper end of the gubernaculum inserted into the inferior pole of the testis or the lateral angle of the uterus, according to gender. The lower end was attached by one or multiple tails, mainly on the pubic bone. This fact explained the clinical findings of ectopic testis. Observations of the abdominal wall and its relationship with the gubernaculum assisted us in explaining the development of the inguinal region, the formation of the inguinal canal, and the presence of the gubernaculum, in both genders. We intend to explain how the deep inguinal ring moves upwards, bringing the gubernaculum along with it, and thus determines the final form of the inguinal canal. Clin. Anat. 22:614–618, 2009. © 2009 Wiley‐Liss, Inc.
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We thank Dr. Rashmi Patil's (Patil, 2009) comments and interest demonstrated on the article (Biasutto et al., 2009). About the numerical mistakes he mentioned, we assume that (1) the number of fetuses dissected were 75. The ''35 females'' was a typing mistake that we did not realize while checking
over the past year and a half, but there has been no recurrence to date, and no sequelae indicative of undue compression or tension on the cord. A description is given at this stage because I consider the method deserves a trial from those with access to a larger number of cases than I could obtain
## Abstract In the period 1945–71, 124 women with primary direct inguinal hernia were operated upon. During the same period indirect inguinal hernias in women were noted to be thirteen times more common than the direct type. The commonest site of protrusion of the direct hernia was immediately medi