The patent processus vaginalis and the inguinal hernia

Abstract

In 1955 Rothenberg and Barnett 1 reported 50 infants and children with unilateral inguinal hernias who had contralateral groin explorations. They concluded that 100 per cent of infants under one year of age and 65.8 per cent of children over one year had “bilateral inguinal hernias.” Since that time there have been many reports confirming the high incidence of an open processus vaginalis on the side opposite a clinically apparent inguinal hernia. Sparkman, 2 in 1962, reviewed a combined series of 918 infants and children with a unilateral inguinal hernia and contralateral groin exploration. A patent processus was found in 57 per cent of the cases. During the past several years, a controversy 3–6 has centered about the significance of the high incidence of patency of the processus vaginalis on the side opposite an inguinal hernia. We have studied a large series of children with inguinal hernias (2764) operated upon by one group of surgeons, in a single hospital. Our objectives were to: (1) determine the natural history of the patent processus; (2) determine the factors that might be associated with patency of the processus; and (3) attempt to find what factors might be related to the development of a clinically apparent inguinal hernia from a patent processus vaginalis.