PED: Inguinoscrotal Swellings

Question 1

Most common hernias in children?

Answer 1

Indirect Inguinal hernias

Question 2

Indirect Inguinal hernia position

Answer 2

Lateral to the inferior epigastric vessels

Question 3

Direct Inguinal hernia position?

Answer 3

Medial to inferior epigastric vessels

Question 4

Femoral hernia position

Answer 4

Inferior to the Inguinal ligament

Question 5

Explain the indirect hernia open repair

Answer 5

Herniotomy, the ligation of the hernia sac via a transverse Inguinal crease incision.

Question 6

In females, surgeons prefer a different type of surgery for indirect Inguinal hernias, what is it, and explain it

Answer 6

Bevan repair, which is closing the sac above the fallopian tube, since injury to such structures is not ideal.

Question 7

Some infants have a posterior wall weakness, which could lead to re-occurrence, what do we do?

Answer 7

Bassini repair to strengthen the area

Question 8

What is an incarcerated hernia

Answer 8

The entrapment of bowel or viscera within the hernial sac

Question 9

What hernia can be confused with an Indirect Inguinal Hernia?

Answer 9

Femoral.

Question 10

What is the Operation for communicating hydrocele/those that persist after 2 years of age

Answer 10

High Ligation of the patent process vaginalis

Question 11

Testicular descent occurs in 2 phases, what are they called?

Answer 11

Trans-abdominal (10-15 weeks) and Inguino-Scrotal (24-35 weeks).

Question 12

Transabdominal phase is regulated via?

Answer 12

INSL3 (insulin-like factor 3)

Question 13

Trans-Scrotal phase is regulated by?

Answer 13

Androgens and Genitofemoral nerve

Question 14

What’s a True UDT compared to Ectopic UDT?

Answer 14

True is along the normal path of descent, but ectopic is one that deviated from such path.

Question 15

Treatment of UDTS?

Answer 15

Orchidopexy at 12 months

Question 16

In UDTS cases associated with Inguinal Hernia, what do we do?

Answer 16

Surgery as soon as possible, to avoid strangulation which is common in these patients

Question 17

Main therapy of a palpable UDT?

Answer 17

Orchidopexy with creation of a sub-dartos pouch.

Question 18

Unilateral non-palpable UDT treatment?”

Answer 18

Laparoscopy.

Question 19

Intravaginal TT are in which age groups

Answer 19

Children and adolescents

Question 20

Intravaginal Torsion characteristic deformity?

Answer 20

Bell-clapper deformity

Question 21

Extravaginal torsion occurs in?

Answer 21

Neonates

Question 22

A positive Prehn sign indicates what, and a negative indicates what??

Answer 22

Positive means Epididymitis, negative is Testicular Torsion