A 4-year-old boy presents with an intermittent groin swelling that descends into the scrotum on crying and reduces on lying down. Surgery reveals a patent sac extending from the deep inguinal ring to the tunica vaginalis. This sac represents persistent patency of the:

• A Gubernaculum proper
• B Sacro-genital fold of peritoneum
• C Processus vaginalis ✓
• D Tunica albuginea evagination

Explanation

During testicular descent the processus vaginalis, an evagination of parietal peritoneum, follows the gubernaculum through the abdominal wall and normally obliterates proximal to the testis by about birth, leaving only the tunica vaginalis. Persistence of the entire processus creates a congenital indirect inguinal hernia, since bowel can herniate along this preformed peritoneal sac into the scrotum. The gubernaculum itself becomes the scrotal ligament and does not form a peritoneal channel. Congenital hydrocele results when only a small distal portion stays patent.

Reference: Gray's Anatomy for Students, 4th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.