A 3-month-old former preterm boy has an intermittent right groin swelling that increases on crying. The swelling is reducible and descends into the scrotum. Regarding management, which statement is correct?
- A It is a direct inguinal hernia and can be observed until school age
- B Surgery is deferred until 2 years unless strangulation occurs
- C It should be repaired soon after diagnosis because of the high risk of incarceration in infancy ✓
- D It is a communicating hydrocele and resolves spontaneously by 1 year
Correct answer: C. It should be repaired soon after diagnosis because of the high risk of incarceration in infancy
Explanation
Groin swelling extending into the scrotum in an infant male is an indirect inguinal hernia from a patent processus vaginalis. Direct hernias are rare in children. In infants, especially preterm boys, the neck of the sac is narrow and the risk of incarceration and strangulation is highest in the first year of life, so repair is undertaken soon after diagnosis rather than deferred. A communicating hydrocele also reflects a patent processus vaginalis but transilluminates and does not reduce with a gurgle; true hernias need operation.
Reference: Bailey and Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.