Ch. 346 - Inguinal hernias Flashcards
MC surgical procedure performed in pediatric surgical practice
Inguinal hernia
The overwhelming majority of inguinal hernias in infants and children are ___ (99%) as a consequence of a patent processus vaginalis (PV)
congenital indirect hernias
Least common type of hernia
Femoral hernia
Approximately 50% of inguinal hernias manifest clinically when
the 1st yr of life, most in the 1st 6 mo
risk of incarceration and possible strangulation of an inguinal hernia is also greatest in what age group
the 1st yr of life (30-40%)
Anatomy of direct inguinal hernia
originates medial to the deep inferior epigastric vessels and is external to the cremasteric fascia; the hernia sac directly through the posterior wall of the inguinal canal
Anatomy of a femoral hernia
originates medial to the femoral vein and descends inferior to the inguinal ligament along the femoral canal
Testes descend to the area of the internal ring by about ___ AOG
28 weeks
Testes descend into the scrotum between ___ AOG
28 and 36 weeks
Inguinal hernias: M vs F
M (6:1)
Inguinal hernias: 60% occur on ___, 30% ___, 10% ___
Right, left, bilateral
Hallmark sign of an inguinal hernia on PE
Smooth, firm mass that emerges through the external inguinal ring lateral to the pubic tubercle and enlarges with increased intraabdominal pressure
Describes the feeling of the layers of the hernia sac as they slide over the spermatic cord structures, with rolling of the spermatic cord beneath the index finger at the pubic tubercle
Silk glove sign
T/F In infants <1 yr of age with inguinal hernia, repair should proceed promptly
T, as many as 70% of incacerated inguinal hernias requiring emergency surgery for reduction and repair occur in the 1st yr of life
T/F An incarcerated, irreducible hernia without evidence of strangulation in a clinically stable patient should initially be managed non-operatively
T
