Mazugis Send the link below via email or IM. The gubernaculum, a mesenchymal structure rich in extracellular matrices, also extends from the caudal pole of the testis. In this article, the embryology, clinical presentation, and management of inguinal hernias are discussed in hernias inguinales pediatria to the pediatric population. Most pediatric ventral and inguinal hernias are detected in the first year of life. Before birth, the layers of the processus vaginalis normally fuse, closing off the entrance into the inguinal canal from the abdominal cavity.
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Inguinal Hernia What is an inguinal hernia? A hernia is present when an opening is present in the abdominal wall through which a sac protrudes from the abdominal cavity through the abdominal wall. In pediatric patients it is generally a congenital abnormality and not something which develops after birth. In adults, these may occur from progressive weakness of the abdominal wall, but this is rarely true in infants, children or teenagers.
A hernia will be apparent if there is a soft bulge in either the inguinal area the crease between the abdomen and the top of the leg or in the scrotum. A hernia that occurs in the groin area is called an inguinal area.
Part of the abdominal contents, such as intestines, can be pushed through this opening. Inguinal hernias occur in 2 percent of all children but are more common in boys than girls. They may occur on either side, but they are more frequent on the right side. What causes an inguinal hernia? The testicles develop in boys in the back of the abdomen just below the kidney. During development of the fetus, the testicle descends from this location into the scrotum pulling a sac-like extension of the lining of its abdomen with it inguinal hernia into scrotum.
This sac surrounds the testicle into adult life, but the connection to the abdomen generally entirely resolves. If this does not occur a hernia will result with the sac extending from the abdomen through the abdominal wall and into the inguinal canal inguinal hernia into canal , where it ends in the groin or it can persist going all the way into the scrotum and the sac surrounding the testicle.
Inguinal hernias are apparent only when there are contents from the abdominal cavity within the sac. In infants and children the sac may not be apparent if contents from the abdominal cavity have not escaped from the abdomen into the sac because the opening in the abdominal wall is too narrow to allow this to occur.
With development, the abdominal wall becomes stronger and can push contents through the opening into the sac often dilating this opening. Some factors place children at higher risk for inguinal hernias such as: prematurity.
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