Frequency of contralateral patent processus vaginalis in children presenting with unilateral hernias

ABSTRACT

To determine the frequency of contralateral patent processus vaginalis [PPV] in children who presented with unilateral inguinal hernias. A Descriptive Study. Department of Paediatric Surgery, Military Hospital Rawalpindi, from November 2006 to November 2007. All children under the age of 6 years and presenting with unilateral inguinal hernia were included. Those children who had a hernia on the contralateral side, or a history of swelling in the past, previous operations on the contralateral side, associated conditions like connective tissue disorders, ascites or VP shunts were also excluded. A standard Rehbein procedure was carried out for hernia repair on both sides. The results were analyzed and presented as mean [range] or mean +/- SD. There were 76 patients who underwent bilateral inguinal explorations. Males were 66 [86.8%] and 10 [10.8%] were female. Almost two thirds [n=52, 68.4%] were children younger than two years of age [mean age 1 year and 9 months]. There was a preponderance of left sided hernias [45 vs. 31, 59.2% vs. 40.8%]. The asymptomatic contralateral side exploration showed the presence of a definite PPV in 5 [6.6%] patients. The mean operating time was 35 + 10.4 minutes. The risk of contralateral hernia, in children presenting with one sided inguinal hernia is quite low. This does not justify routine exploration of the contralateral groin to prevent only a few clinical hernia developments later on