Direct hernia and indirect hernia are two types of inguinal hernia. An inguinal hernia is a protrusion of parietal peritoneum and possibly pelvic and abdominal structures into the inguinal canal. They are classified as direct or indirect.
An indirect inguinal hernia occurs when tissue protrudes the deep inguinal ring travels into the canal and then exits the superficial inguinal ring. It is described as lateral to the arteries and veins of the inguinal canal.
A direct inguinal hernia occurs when tissue protrudes through the floor of the canal. It is described as lying medial to the vascular structures.
Indirect hernias are more typical in young men and direct inguinal hernias are more typical in older males, although it can be difficult to discern on physical exam.