What term is used to refer to a hernia when both a direct and indirect hernia is present?

The term used to describe the presence of both a direct and an indirect inguinal hernia simultaneously is "pantaloon." This term is derived from the description of the two types of hernias as resembling a pair of pants, with the direct hernia essentially being on one side and the indirect hernia on the other. This dual presentation can occur because both types of hernias emerge in the inguinal canal but through different anatomical pathways—direct through the posterior wall of the canal and indirect through the deep inguinal ring.

The other options refer to different types of hernias. An incisional hernia is one that occurs at the site of a previous surgical incision. An inguinal hernia is a broader term that encompasses both direct and indirect hernias but does not specify their coexistence. A paraumbilical hernia occurs near the umbilicus and is unrelated to the inguinal canal anatomy. Thus, the term "pantaloon" specifically identifies the unique scenario of having both direct and indirect inguinal hernias present.