Direct inguinal hernias push through the floor of the inguinal canal (Hesselbach’s triangle, medial to inferior epigastric vessels) due to weak transversalis fascia. Indirect hernias follow the patent processus vaginalis through the deep ring (lateral to vessels), often congenital. Both can contain bowel but differ in pathway and risk.

Direct Inguinal Hernia vs Indirect Inguinal Hernia Regional Anatomy Diagram
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