A 3-month-old boy has an intermittent groin swelling that appears on crying and reduces spontaneously on lying down. On examination, the swelling descends to the scrotum, transmits no cough impulse equivalent, and the testis is separate and normal. The definitive operative step in this condition is:
- A Bassini repair of the posterior canal wall
- B Laparoscopic mesh repair of the myopectineal orifice
- C Herniotomy: high ligation of the patent processus vaginalis at the internal ring ✓
- D Shouldice repair with overlapping fascial layers
Correct answer: C. Herniotomy: high ligation of the patent processus vaginalis at the internal ring
Explanation
Paediatric inguinal hernias are almost always indirect, caused by persistence of the processus vaginalis, and there is no true muscular floor defect. Simple division and high ligation of the sac at the internal ring (herniotomy) is curative in infants and children. Mesh repairs such as Lichtenstein and tissue repairs like Bassini or Shouldice address adult groin floor weakness, which does not exist in a 3-month-old, making them inappropriate here.
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.