Interparietal Hernias

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The term “interparietal hernia” is used collectively to designate a group of rather unusual hernias which are located in the inguinal region between the various layers of the abdominal parietes. Anatomically, these hernias may be classified as follows: (1) Properitoneal hernia, that type in which the hernial sac lies between the peritoneum and the transversalis fascia; (2) interstitial hernia, in which the sac lies between the transversalis fascia and the trans-versalis, internal oblique, or external oblique muscles; and (3) superficial hernia, in which the sac is situated between the aponeurosis of the external oblique muscle and the integument.

Since interparietal hernia has been spoken of by all authorities as being of rare occurrence it is surprising to find that 587 cases have been reported in the literature. The inability to diagnose this condition pre-operatively and the consequent high mortality rate indicate how superficial is our knowledge of this type of hernia. Since the days of Thomas Bartholin (1661), many noted surgeons have been chagrined because they failed to recognize this type of hernia at the operating table, the mistake being revealed at necropsy.

Because of these considerations, we feel justified in presenting a clinical study of interparietal hernias based on cases observed at the Cleveland Clinic and those reported in the literature.

Two Cases of Interstitial Hernia

Case I.—The patient, a truck driver, aged fifty-eight, reported at the Cleveland Clinic April 27, 1929, complaining of pain occurring low in the left side.

Four years previously, a severe pain suddenly. . .



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