Title

The risk of developing a symptomatic inguinal hernia in children with an asymptomatic patent processus vaginalis.

Document Type

Article

Publication Date

1-1-2017

Identifier

DOI: 10.1016/j.jpedsurg.2016.10.018

Abstract

BACKGROUND: Children with a symptomatic indirect inguinal hernia have a patent processus vaginalis (PPV). However, the reverse is unknown, as the natural history of PPV is unclear. Currently, there are little data regarding the incidence and time frame for developing a symptomatic hernia with a known asymptomatic PPV.

METHODS: A retrospective chart review was conducted in children who were evaluated for a PPV during nonhernia laparoscopic surgery by a single pediatric surgeon (GWH) from 2000 to 2014. Those patients with intraoperative findings of PPV were followed up by chart review and phone inquiry.

RESULTS: 1548 children underwent a laparoscopic operation, with 308 having an asymptomatic PPV. Phone contact was successful in 125 (43%) of these patients at a median of 8.1years (range 4.8-12.7) after the initial laparoscopic operation. Nineteen (13%) patients returned with a symptomatic hernia at a median age of 17months (range: 5-74) and a median presentation of 9months (range: 1-66) after the initial laparoscopy. Ten hernia repairs were unilateral and 9 bilateral. None of those who were contacted via phone inquiry reported hernia symptoms or hernia repair.

CONCLUSIONS: These data suggest that the risk of developing a symptomatic hernia during childhood in the presence of a known PPV is relatively low.

LEVEL OF EVIDENCE: Level 3; type of study: retrospective study.

Journal Title

Journal of pediatric surgery

Volume

52

Issue

1

First Page

60

Last Page

64

MeSH Keywords

Adolescent; Asymptomatic Diseases; Child; Child, Preschool; Female; Follow-Up Studies; Hernia, Inguinal; Humans; Incidence; Infant; Infant, Newborn; Laparoscopy; Male; Peritoneal Diseases; Postoperative Complications; Retrospective Studies; Risk Factors

Keywords

Asymptomatic patent processus vaginalis; Children; Inguinal hernia; Laparoscopy; Teenagers; Children

Comments

LEVEL OF EVIDENCE:

Level 3; type of study: retrospective study.

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