An 18-month-old boy has a left scrotal swelling whose size varies through the day, being largest in the evening and smaller in the morning. It transilluminates brilliantly and the testis is palpable within it. The most appropriate treatment is:
- A High ligation of the patent processus vaginalis through a groin incision ✓
- B Excision of the tunica vaginalis sac
- C Lord's plication procedure
- D Aspiration and sclerotherapy
Correct answer: A. High ligation of the patent processus vaginalis through a groin incision
Explanation
C hydrocele that changes size with posture indicates a communicating hydrocole due to a patent processus vaginalis, analogous to a congenital indirect inguinal hernia. The correct operation is herniotomy, that is high ligation of the processus at the internal ring through a groin incision, which cures the communication. Scrotal procedures such as evaporation, excision or Lord's plication address adult primary hydrocoele and leave the communication untouched. Aspiration and sclerotherapy are unsuitable in children.
Reference: Pediatric Surgery NaT, APSA reference ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.