A 6-month-old boy has a reducible right inguinal hernia. What is the accepted operative management?
- A McVay repair via a lower groin incision
- B Herniotomy plus Lichtenstein mesh repair
- C Herniotomy (high ligation of the sac at the deep ring) alone ✓
- D Observation until 2 years of age, since most close spontaneously
Correct answer: C. Herniotomy (high ligation of the sac at the deep ring) alone
Explanation
Infantile inguinal hernias arise from a patent processus vaginalis, and in children with normal musculature simple high ligation of the sac at the internal ring cures the hernia; no floor reconstruction or mesh is required. Waiting is unsafe because the risk of incarceration in infants is high and the processus vaginalis does not reliably close after infancy. Mesh repair is reserved for recurrent cases or connective tissue disorders.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.