Congenital Hernia and

Hydrocele
• Hernia : Protrusion of viscus through a
normal or abnormal opening in the
abdomen

• Hydrocele : Collection of fluid in the

tunica vaginalis sac
 Patent processus vaginalis
• Outpouching of the peritoneal cavity
through deep ring along with the
descending testis.

• Distal processus remains as tunica

vaginalis

• Proximal part from deep ring to testis

obliterates
 HERNIA HYDROCELE

• Wide neck, so • Narrow neck, so

viscera herniates only peritoneal fluid
collects
• H/o inguinal swelling • H/o scrotal swelling
on crying or with diurnal size
coughing variation
• Not reducible
• Fluctuant and
• Often completely
transilluminant
reducible
DIAGNOSIS : CLINICAL
 HERNIOTOMY : LIGATION OF THE
PROCESSUS VAGINALIS SAC AT THE
DEEP RING
HERNIA HYDROCELE

As early as possible Wait till 2 yrs

because of
complications Usually resolves

If not surgery at 2 yrs

 Complications of Hernia
• Irreducibility

• Obstruction

• Strangulation

• If ovary is a content - Torsion

 UMBILICAL HERNIA

Failure of closure of fascial ring through

which the umbilical cord protrudes at
birth causes the development of
umbilical hernia.
• common in low birth weight infants

• occurs with Down’s syndrome,

congenital hypothyroidism, Beckwith-
Wiedemann syndrome
• Seen as a bulge at umbilicus.

• On crying, this mass expands.

• Reducible .

• Digital exam- well defined rim .

• Complications –incarceration.
- erosion of skin.
• most hernias close spontaneously by
4 to 5 years of age.

• Treatment - surgical repair

 1.persistent hernia.
2.large hernia.(fascial defect more
than 1.5 cms)
3.complicated hernia