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

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.

• Authors: Katrina L Weaver, Ashwini S Poola, Joanna L Gould, Susan W Sharp, Shawn D St Peter, George W Holcomb 3rd
• Journal: Journal of pediatric surgery (J Pediatr Surg) Vol. 52 Issue 1 Pg. 60-64 (Jan 2017) ISSN: 1531-5037 [Electronic] United States
• PMID: 27842956 (Publication Type: Journal Article)
• Copyright: Copyright © 2017. Published by Elsevier Inc.

Topics

• Adolescent
• Asymptomatic Diseases
• Child
• Child, Preschool
• Female
• Follow-Up Studies
• Hernia, Inguinal (diagnosis, epidemiology, etiology)
• Humans
• Incidence
• Infant
• Infant, Newborn
• Laparoscopy
• Male
• Peritoneal Diseases (complications, diagnosis)
• Postoperative Complications (diagnosis, epidemiology, etiology)
• Retrospective Studies
• Risk Factors