This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
Hernia that is least likely to strangulate is ? 
Select and explain. 
A. Femoral hernia, B. Direct inguinal hernia, C. Indirect inguinal hernia, D. Umbilical hernia
B: Direct inguinal hernia
Answer: B: Direct inguinal hernia 
Explanation: Ans. is 'b' i.e., Direct inguinal hernia "As the neck of the sac is wide direct inguinal hernias do not often strangulate".A hernia is said to be strangulated when the blood supply of its content is seriously impaired.Most constricted pa of the hernia is its neck.Therefore strangulation develops in hernias in which neck is constricted.Femoral hernias have the highest rate of all strangulated hernias (5-20%) because the neck of the femoral hernia is very narrow.Indirect inguinal hernias do not strangulate as often as femoral hernias but strangulate more than direct hernia.In umbilical hernia strangulation varies with age ?- In infants the hernias closes spontaneously so there is no chance of strangulation.- In adult strangulation is a frequent complication.