The external oblique aponeurosis is contiguous into the scrotum as the external spermatic fascia. Near the medial attachment of the external oblique aponeurosis onto the pubic tubercle the aponeurosis divides forming the external inguinal ring, through which the spermatic cord and testicle descend. It is separated from the underlying peritoneum by a layer of preperitoneal connective tissue and fat. Occurs when bowel, omentum, or another intraabdominal organ protrudes through the abdominal ring within the peritoneal coverage of a patent processus vaginalis. It is a congenital lesion secondary to patency of processus vaginalis.
Indirect hernias protrude lateral to the inferior epigastric vessels.
Because of the lower incidence of incarceration and strangulation a more relaxed approach to their repair is tolerated. In women, this ring is also present, despite the absence of testicular vessels. A hernia exists when the inguinal ring enlarges to the point where a bowel can pass through it. Hernias most often cause pain in the groin. Often, a lump is felt in the groin area.