In paediatric inguinal hernia, the key anatomical distinction from adults is that indirect inguinal hernia in infants results from:

• A Patent processus vaginalis persisting after testicular descent ✓
• B Weakness of the posterior wall of the inguinal canal (transversalis fascia)
• C Enlargement of the deep inguinal ring due to increased intra-abdominal pressure
• D Congenital absence of the cremaster muscle

Explanation

In children, indirect inguinal hernia results from a patent processus vaginalis — the peritoneal diverticulum that accompanies the testis in its descent. It normally obliterates after birth. In infants, herniotomy (ligation and division of the sac at the deep ring, without any floor repair) is sufficient, unlike adults where floor repair (Bassini, Lichtenstein) is required due to acquired muscular weakness. Right-sided hernias predominate due to later descent of the right testis.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.