 Today we will be discussing cross-sectional imaging of the pantalones hernias. Abdominal hernias can be external hernias when they pass through the entire abdominal wall and project anteriorly or they can be internal hernias when they affect the internal peritoneal structures. The groin is the most commonly affected area with the hernias. If we can see this is the anti-superial iliac spine and this is the region of the pubic bone. A ligamentous linear structure is seen connecting both these structures and it is called as inguinal ligament. When the hernia occur above this inguinal ligament they are called as inguinal hernias and when they occur below it they are called as femoral hernias. Another structure to be seen are these infir epigastric vessels. When the hernia occurs medial to these infir epigastric vessels then they are called as direct inguinal hernias and when they occur lateral to this infir epigastric vessel they are called as indirect inguinal hernias. These indirect inguinal hernias are more common compared to the direct inguinal hernias. Pentalone hernias are special type of hernia when both direct and indirect inguinal hernias are present in the same case on the same side, on the both the sides of infelioepigastric vessel concurrently and this is a special type of hernia and we will be emphasizing on that. The femoral hernia occur below the inguinal ligament, when we see appendix inside the inguinal hernias they are called as amiens hernia and when we see appendix within the femoral hernia they are called as digrengotes hernias. Now coming to the anatomy of the inguinal region, this is the rectus abdominis muscle and this is the lateral margin of it, these are the infelioepigastric vessels and this is the inguinal ligament, this is the internal inguinal ring and these are the vessels coming out of it and here will be the position of the inguinal canal. So this triangle which is called as Heselbeck's triangle occurring medial to this infelioepigastric vessels is important structures and any hernia coming out of it is direct inguinal hernia. So we have to see this linear structures which are seen on these are the structures if you can see in during the movement. So these two are the inguinal ligaments which we have to see and second structure we have to see are this infelioepigastric vessels which run like this and on hernias can these are the infelioepigastric vessels, again we can see these are the infelioepigastric vessels and these are the infelioepigastric vessels from both the sides. According to the inguinal hernias these are the most common hernias which occur in both men and women but are more common in men. The contents is variable and they may contain bowel, fat or sometimes appendix or mackles, diverticulum or at times bladder also. The indirect inguinal hernias as we know are more common, they occur to the patent processes vaginalis, they occur lateral to the infelioepigastric vessels and they pass through the inguinal canal unlike the direct inguinal hernia which pass through the defect in the transversal isphatia. Now let us see if you can see this hernia neck here and you can see this vessel which is infelioepigastric artery which is lateral to the neck of the hernia so this hernia is coming down and you can see this infelioepigastric vessel lying lateral to it. So this is a direct inguinal hernia and as we go down we can see also some amount of fluid in the infelio portion of the direct inguinal hernia. We can create the VRTs of the abdominal muscles like this and can show the direct inguinal hernia. Compared to this, this is a case of indirect inguinal hernia and we can see some hernia coming out through the internal inguinal ring then passing through the internal inguinal ring, this is the inguinal canal, this is the extra inguinal ring and then which is going towards the scrotal region. Even if we can see superiorly the infelioepigastric vessels here, these are the infelioepigastric vessels, they were lying medial to the hernia and that is why it is indirect hernia. Now this is a case, we are not seeing any of the hernia sac which is at the resting stage and we can ask the patient to strain or blow or cry or do some maneuvers so that this small hernias can be seen. So, this is also one way to see the small hernias. There is one nomenclature of this indirect inguinal hernias. When the indirect inguinal hernia just passes through the internal inguinal ring and just do not cross the inguinal canal to reach up to the external inguinal canal, they are called as mubnosil. The hernia which cross internal inguinal ring as well as external inguinal ring but does not reach up to the scrotum, the hernia which cross both internal as well as external inguinal ring and also reach up to the scrotal are called as inguinal scrotal hernias.