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[Inguinal hernias in children]
1Service de chirurgie pédiatrique viscérale et urologique, Hôpital Robert Debré, 75935 Paris.
Insights
Inguinal hernia repair is a common pediatric surgery, often caused by a patent processus vaginalis. Early surgical intervention is recommended to prevent complications like incarceration and ensure the best outcomes for children.
Area of Science:
- Pediatric Surgery
- Anatomy
- Developmental Biology
Context:
- Inguinal hernias are the most frequent surgical procedure in children.
- Most pediatric inguinal hernias are indirect, resulting from a patent processus vaginalis.
- Failure of the processus vaginalis to close leads to inguino-scrotal abnormalities.
Purpose:
- To describe the etiology and management of inguinal hernias in children.
- To highlight the common complications and their consequences.
- To emphasize the importance of timely surgical repair.
Summary:
- Patent processus vaginalis is the primary cause of indirect inguinal hernias in infants and children.
- In girls, a patent canal of Nuck can lead to ovarian or fallopian tube entrapment.
- Incarceration is a frequent complication, particularly in the first year of life, risking testicular blood supply and intestinal vitality.
- Recurrence rates are low (0.5-1%) after uncomplicated repairs but increase with prematurity and complicated hernias.
Impact:
- Informs surgical decision-making for pediatric inguinal hernias.
- Underscores the critical need for prompt diagnosis and surgical repair to mitigate risks.
- Provides data on recurrence rates, aiding in patient counseling and follow-up planning.
Abstract:
The inguinal hernia repair account among surgical procedures the most frequently performed in children. Most inguinal hernias in infants and children are indirect due to patent processus vaginalis. Failure of closure of the processus vaginalis accounts for nearly all the inguino scrotal abnormalities seen in infancy and childhood. In little girls, the processus (canal de Nuck) may remain patent and may allow the ovary and fallopian tube to enter the inguinal region. Incarceration represents the most common complications associated (30 per-cent during the first year of life). Consequences concern in the first place the testicular blood supply before to interest the vitality of the incarcerated intestine. The surgically repair is recommended shortly after the diagnosis. The concurrence rate of recurrent inguinal hernia after uncomplicated inguinal hernia repairs is generally reported at 0.5-1 per cent, increasing for premature infant and complicated inguinal hernia.
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