At its most inferior aspect the aponeurosis of external oblique folds back on itself to form the inguinal ligament and inguinal canal. This is an important component of the anterior abdominal wall since it contains two potential openings for the development of hernias. The first opening is the deep inguinal ring traditionally described as lying immediately lateral to the inferior epigastric artery, though in several studies(1,2,3) this has been shown to be variable. The second opening is the superficial inguinal ring located just superolateral to the pubic tubercle.

The location of the inguinal ligament.

Oblique coronal reconstruction demonstrating the inguinal ligament (white arrowheads); the pubic tubercle (black arrowhead) and the anterior superior iliac spine (open arrowhead).

References

1. Conaghan P, Hassanally D, Griffin M, Ingham Clark C. Where exactly is the deep inguinal ring in patients with inguinal hernias? Surg Radiol Anat. 2004;26(3):198-201.

2. Andrews BT, Burnand KG, Ferrar D. Putting a finger on the deep inguinal ring. J R Coll Surg Edinb. 1996;41(2):90-92.

3. Sanjay P, Reid TD, Bowrey DJ, Woodward A. Defining the position of deep inguinal ring in patients with indirect inguinal hernias. Surg Radiol Anat. 2006;28(2):121-124.