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

Abstract

Abstract Introduction: Inguinal hernia (IH) is a daily practice for pediatric surgeons. In a developing country with limited facilities predicting and diagnosing a contralateral patent processus vaginalis (PPV) is important to avoid the risk and cost of further surgery. Objectives: To assess accuracy of ultrasound in detecting PPV was our main objective using laparoscopic evaluation as a confirmatory test. We also looked for different predictors for PPV in our study population. Methods: One hundred forty-one patients were included in this 2-year cross-sectional prospective study; each patient was assessed in outpatient clinics then had a pre-operative ultrasound. This was followed by laparoscopic evaluation during repair of the hernia. Inclusion criteria were bilateral inguinal hernia elective patients, with no major comorbidities and age between 2months to 8years. Results: A total of 141 patients were included, 110 (78%) were males, 121 (85.9%) were full term and 96 (68.1) had right side hernia. Mean age 2.64 ± 1.9. The Ultrasound sensitivity showed 85.7% sensitivity, specificity 90.8%, and accuracy 90.1%. We analyzed other predictors with age less than 1 year, right side hernia and defect size more than 10mm were statistically significant predictors for a contralateral PPV. Conclusion: ultrasound has a high accuracy profile and is a beneficial alternative in the instances of limited settings and restricted access to minimally invasive surgery. Patients with age less than one year, right side hernia or larger manifested hernia defect has higher risk of having contralateral PPV.