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. 2023 Nov 24;40(1):9.
doi: 10.1007/s00383-023-05576-x.

Patent processus vaginalis: role of ultrasound in pediatric population with unilateral inguinal hernia and other predictors

Yehia S Abdelmotaal  1   2 , Heba Taher  3 , Sherif Kaddah  3 , Mohamed Elbarbary  3 , Karam Elsayem  4
Affiliations

Patent processus vaginalis: role of ultrasound in pediatric population with unilateral inguinal hernia and other predictors

Yehia S Abdelmotaal et al. Pediatr Surg Int. .

Abstract

Introduction: Inguinal hernia (IH) repair is a common procedure in the daily practice of pediatric surgeons. In a developing country with limited facilities, it is important to be able to predict and diagnose contralateral patent processus vaginalis (CPPV) to avoid the risk and cost of further surgery.

Objectives: To assess the accuracy of ultrasound for the detection of CPPV, using laparoscopic evaluation as a confirmatory test. We also looked for various predictors of CPPV in our study population.

Methods: 141 patients were included in this 2-year, cross-sectional prospective study. Inclusion criteria were unilateral inguinal hernia elective patients with no major comorbidities and aged between 2 months and 8 years. Each patient was assessed in outpatient clinics and then a pre-operative ultrasound was conducted. This was followed by laparoscopic evaluation during repair of the hernia.

Results: Of the 141 patients included, 110 (78%) were males, 121 (85.9%) were born at full term, and 96 (68.1) had right-sided hernia. Mean age was 2.64 ± 1.9 years. Ultrasound was 85.7% sensitive in the detection of CPPV, 90.8% specific, and 90.1% accurate. In our analysis of patients younger than 1 year, right-sided hernia and defect size more than 10 mm were statistically significant predictors for a CPPV.

Conclusions: Ultrasound has a high accuracy profile and is a useful alternative in limited resource settings with restricted access to minimally invasive surgery for the prediction of CPPV. Patients younger than 1 year with a right-sided hernia or a manifested hernia defect larger than 10 mm are at a higher risk of having a CPPV.

Keywords: Pediatric inguinal hernia; Predictors of PPV; Ultrasound for PPV.

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References

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