A 3-month-old male infant has an irreducible right groin swelling that appeared during crying. The swelling extends to the scrotum, is tense, and the child is vomiting. After appropriate resuscitation and sedation, manual taxis fails. What is the operation of choice?

• A Laparoscopic mesh repair of the myopectineal orifice
• B Open herniotomy via the inguinal approach with assessment of testicular and bowel viability ✓
• C McVay repair with division of the inguinal ligament
• D Contralateral open exploration with bilateral herniotomy in all cases

Explanation

Strangulated inguinal hernia in infancy requires emergency exploration through the groin. Because the transversalis fascia and posterior wall are inherently strong in children, simple high ligation of the sac (herniotomy) is curative, and floor repairs used in adults are unnecessary. Mesh is avoided in infants. Routine contralateral exploration is no longer standard practice given laparoscopic assessment options and low metachronous rates. Bowel viability is assessed before reduction or resection.

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.