title: A peculiar variety of indirect inguinal hernia (juxtacordal indirect inguinal hernia).
abstract: BACKGROUND
  Indirect inguinal hernias are usually congenital, forming a sac in the core of the spermatic cord covered by the internal spermatic, cremasteric, and external spermatic fasciae(1-3). Direct inguinal hernias are acquired; the sac lies beside/behind the cord(1-3). A rare third type is a combination of indirect and direct sacs on both sides of inferior epigastric vessels(1-3). We describe a rare fourth type, juxtacordal indirect oblique inguinal hernia (Fig. 1), in which the sac emerges through a weakness in the deep inguinal ring, lateral to inferior epigastric vessels, and passes into the inguinal canal beside and in contact with the cord but outside of its covering fasciae.
  
  
  OBJECTIVE
  Describes a very rare variety of inguinal hernia.
  
  
  METHODS
  Case reports.
  
  
  METHODS
  Tikrit Teaching Hospital/Salahuddin/Iraq.
  The first case; a 5-year-old male with right inguinal hernia, the second case; a 25-year-old man with right inguinal hernia, the third case; a 60-year-old man with right inguinal hernia.
  
  
  METHODS
  Surgery has been done electively for all.
  
  
  CONCLUSIONS
  Because the sac emerges through the deep inguinal ring and passes through the inguinal canal, it is an indirect type and because it passes beside the spermatic cord we call it juxtacordal hernia. Because of the thick extraperitoneal fat layer over the sac, we think this hernia is acquired.
  
  
  CONCLUSIONS
  Knowing this type of hernia might reduce the risk of inferior epigastric vessels injury and lower the rate of recurrence.
authors.affiliation: College of Medicine, Tikrit University, Tikrit, Iraq.
authors.forename: Harith M
authors.initials: HM
authors.lastname: Alkhateeb
authors.affiliation: College of Medicine, Tikrit University, Tikrit, Iraq.
authors.forename: Thaer J
authors.initials: TJ
authors.lastname: Aljanabi
keywords: Direct; Indirect; Inguinal hernia; Juxtacordal; Pantaloon