Hesselbach's triangle

Hesselbach’s triangle is a triangular region in the lower posterior aspect of the anterior abdominal wall (see yellow inset in the image). It is bound medially by the lateral border of the rectus abdominis muscle, superolaterally by the inferior (deep) epigastric vessels (label “C”) and by the inguinal ligament inferolaterally.

Hesselbach’s triangle is described as the area where a direct inguinal hernia will extrude from posterior to anterior, to protrude directly (hence the name) through the external (superficial) inguinal ring.

Franz Kaspar Hesselbach (1759-1816) was a German surgeon and anatomist who described inguinofemoral hernias in detail, publishing several books on the subject. His name is attached to several regions and structures:

• Hesselbach’s triangle, described in this article

• Hesselbach’s fascia. Known as the cribriform fascia, this perforated fascia covers the saphenous opening in the superior femoral region.

• Hesselbach’s ligament. Also known as the interfoveolar ligament, this is a thickening of the transversalis fascia in relation to the inferior (deep) epigastric vessels. 

If you click on the picture, an original image by Hesselbach will appear. This image shows a defect in Hesselbach’s triangle, setting the stage for a direct inguinal hernia, as well as the interfoveolar ligament. Incidentally, Hesselbach's triangle as described today is not the area described originally by Dr. Hesselbach, where the lower border of the triangle was Cooper's ligament.

Initial image property of:CAA.Inc.. Artist:M. Zuptich. Secondary image by F.K. Hesselbach.

Clinical anatomy of the inguinofemoral hernias, as well as abdominal and perineal hernias are some of the lecture topics developed and delivered to the medical devices industry by Clinical Anatomy Associates, Inc. For more information Contact Us.