Congenital Hernia and

Hydrocele

• Hernia : Protrusion of viscus through a normal or abnormal opening in the abdomen

• Hydrocele : Collection of fluid in the tunica vaginalis sac

Patent processus vaginalis

• Outpouching of the peritoneal cavity through deep ring along with the descending testis.

• Distal processus remains as tunica vaginalis

• Proximal part from deep ring to testis obliterates

HERNIA

• Wide neck, so viscera herniates

• H/o inguinal swelling on crying or coughing

• Often completely reducible

HYDROCELE

• Narrow neck, so only peritoneal fluid collects

• H/o scrotal swelling with diurnal size variation

• Not reducible• Fluctuant and

transilluminant

DIAGNOSIS : CLINICAL

HERNIOTOMY : LIGATION OF THE PROCESSUS VAGINALIS SAC AT THE

DEEP RINGHERNIA

As early as possiblebecause of

complications

HYDROCELE

Wait till 2 yrs

Usually resolves

If not surgery at 2 yrs

Complications of Hernia

• Irreducibility

• Obstruction

• Strangulation

• If ovary is a content - Torsion

UMBILICAL HERNIA

Failure of closure of fascial ring

through which the umbilical cord

protrudes at birth causes the

development of umbilical hernia.

• common in low birth weight infants

• occurs with Down’s syndrome, congenital hypothyroidism, Beckwith-Wiedemann syndrome

• Seen as a bulge at umbilicus.

• On crying, this mass expands.

• Reducible .

• Digital exam- well defined rim .

• Complications –incarceration. - erosion of skin.

• most hernias close spontaneously by 4 to 5 years of age.

• Treatment - surgical repair

1.persistent hernia. 2.large hernia.(fascial defect

more than 1.5 cms) 3.complicated hernia