ABSTRACT
Our study was carried on 393 infants and children at Pediatric Surgical Unit-Al Azhar University Hospitals in the period from January 1997 to January 1998. Their ages ranged from 0-12 years and followed for sixteen months. The need for contralateral inguinal exploration in children during unilateral inguinal hernia repair remains controversial. We questioned whether an elective preoperative sonographic examination of the contralateral inguinal canal was accurate enough to prevent unnecessary exploration of the asymptomatic side with no late appearance of a contralateral inguinal hernia. Sonograophy [US] of the groin was performed to 100 children [group I] awaiting unilateral hernia repair over a 1 year period during 1997-1998. 200 children [group II] with unilateral inguinal hernia underwent unilateral repair without preoperative groin US during the same period. Also groin US was done for 50 normal infants and children [group III] for measurement of the diameter of the internal inguinal ring. The two groups of patients [I and II] and their medical records were reviewed in April 1999, sixteen months following surgery. Of the group I, 87 patients had the clinical diagnosis of unilateral hernia confirmed by US. 13 patients with groin US evidence of a contralateral hernia based on the diameter of internal inguinal ring [> 3mm in infant below one year > 4 mm in children between 12-24 months and > 5 mm in children older than 24 months]. At the follow up 14 patients [7%] in group II presented with a hernia in the opposite groin 1 to 16 months following surgery. Non of the patients in group I presented with a clinically evident hernia during the follow-up period. These findings suggest that US is a readilyavailable, non invasive, and accurate method of preoperative evaluation of the groin. Our policy of contralateral exploration based on the US findings was shown to be reliable in preventing unnecessary surgical exploration of the unaffected inguinal canal