Inguinal hernia and hydrocoele Flashcards
What fails to close in boys?
processus vaginalis
what is the processus vaginalis?
diverticulum of peritoneum
What fails to close in girls which leads to inguinal hernia?
fail to obliterate the canal of nuck
what distinguishes between a hernia and hydrocoele?
degree of patency of the persistent processus vaginalis
what is an inguinal hernia?
protrusion of intra-abdominal contents through a patent processus vaginalis
what is a hydrocoele?
collection of fluid formed by the omentum in the space between the tunica vaginalis and testis
incidence
2%
incidence in prematurity
20%
boy:girl ration
5:1
which side is more common?
60% right sided
30% left sided
10% bilateral
why is there a higher incidence on the right?
right testis descends later than the left so processus more likely to remain patent
presentation of hernia
groin swelling extend toward scrotum or labia
first few weeks/months of life
evident on strain/crying
if hernia is reduced what may examination reveal?
thickening of spermatic cord on affected side
hydrocoele presentation
scrotal swelling after birth
fluctuate in size
non specific viral illness
diagnosing inguinal hernia
history - intermittent groin swelling
easily reducible
thickened spermatic cord
are hydrocoeles reducible?
no
3 differences between hydrocoele and inguinal hernia
irreducible
transilluminate
do not extend into groin
what can be done to distinguish hydrocoele and hernia?
inguinoscrotal USS
patency of PV
why is surgical repair of inguinal hernia importnat?
risk of incarceration
risk of incarceration and 6 and 2 rule
higher in younger infants
<6 weeks fix in 2 days
<6 months fix in 2 weeks
>6 months = fix 2 months
when is hydrocoele surgery done?
after 2 years old
why is hydrocoele surgery done?
fluid around testis may elevate temperature and affect fertility
inguinal hernia - first incision
skin crease incision in groin
inguinal hernia op - where is first incision dissected down to?
external oblique
