1. Inguinal Hernia and Hydroceles
Reference
Pediatric Surgery 7th ed (2012)
Ashcraft's Pediatric Surgery (2010)

2. Embryology and Pathogenesis
Indirect inguinal hernias are fundamentally the result of failure of closure of the processus vaginalis
(patent processus vaginalis, PPA).
Note
Patent a. e.g. patent ductus arteries (PDA)
patent foramen ovale
opp. obliterative adj.
obliteration n.

3. Clinical Features
1. Inguinal hernias are generally found by parents at bath time or during well-child examinations by their pediatricians
2. There is typically a history of intermittent bulge in the groin, labia, or scrotum.
3. It is most often apparent when there is increased intra-abdominal pressure such as during episodes of crying or straining

4. Notes history n. e.g. present history of ~
bulge n. His eyes seemed to bulge like those of a frog
increased/decreased a. (commonly used in medical writings)

5. Physical Examination(PE)
An infant may be allowed to strain or cry to provoke an inguinal bulge to appear
If a mass is still not present, the spermatic cord can be palpated to determine thickening
Note
1. Palpate v. e.g. palpate the abdominal mass
2. present v e.g. present a history with….
n. / a. e.g. the presence of a tumor

6. Radiologic Investigations
In most cases the diagnosis of an inguinal hernia can be made by history and physical examination alone.
Note. make the diagnosis of ~
e.g. Diagnosis of malignant tumors could only be made by pathological examinations.

7. Surgery
The fundamental principle guiding pediatric inguinal hernia repair is high ligation of the hernia sac
One major advantage of laparoscopic repair is
contralateral exploration.
(Surgically-related terms)

8. Complications Recurrence Injury to the Vas deference Scrotal swelling
Testicular atrophy
Iatrogenic undescended testicle
(e.g. iatrogenic injury)

9. Thank You! Good Morning!