The inguinal triangle (Hesselbach’s triangle) is a region located in the anterior abdominal wall, also known as the medial inguinal fossa. It was described by German surgeon and anatomist, Frank Hesselbach, in 1806. In this article, we will discuss the anatomy of the inguinal triangle – its borders, contents, and clinical relevance.
The inguinal triangle is situated in the inferomedial aspect of the abdominal wall, and is bordered as follows:
Aside from the layers of the abdominal wall, no structure of clinical importance is located within the inguinal triangle. However, it does pertain to an area of potential weakness in the abdominal wall, where herniation of the abdominal contents can occur.
A hernia is defined as the protrusion of an organ or fascia through the wall of a cavity that typically contains it. The inguinal triangle is one of the more common areas of weakness in the abdominal wall, and is the location of a direct inguinal hernia. This type of hernia occurs when the bowel herniates medially to the inferior epigastric vessels, through the inguinal triangle and into the inguinal canal. When the herniated bowel exits the canal through the superficial inguinal ring, a 'lump' can be seen in the scrotum or labia majora. Direct hernias are usually acquired in adulthood, and are caused by weakening in the abdominal musculature. This is distinct from an indirect inguinal hernia, which is where the bowel enters the inguinal canal via the deep inguinal ring.
The inguinal triangle (Hesselbach's Triangle) is a common anatomical region situated in the lower abdomen. It is bounded laterally by the lateral border of the rectus abdominis muscle, and medially by the medial edge of the adductor longus muscle. The direct inguinal hernia occurs most commonly within the inguinal triangle. It usually results from weakening of the abdominal wall which allows structures to herniate into the inguinal canal through the inguinal triangle.