True regarding indirect inguinal hernia are all except: March 2008
Ans. B: Always unilateral Indirect inguinal hernia is the most common type of hernia and occurs commonly in the young In the first decade it is more common on the right side. The hernia is bilateral in 12% of cases. In boys, differentiating between a hernia and a hydrocele is not always easy. Transillumination has been advocated as a means of distinguishing between the presence of a sac filled with fluid in the scrotum (hydrocele) and the presence of bowel in the scrotal sac. However, in cases of inguinal hernia incarceration, transillumination may not be beneficial because any viscera that is distended and fluid-filled in the scrotum of a young infant may also transilluminate. A rectal examination may be helpful if intestine can be felt descending through the internal ring. * Silk sign: When the hernia sac is palpated over the cord structures, the sensation may be similar to that of rubbing 2 layers of silk together. This finding is known as the silk sign and is highly suggestive of an inguinal hernia. The silk sign is paicularly impoant in young children and infants, in whom palpation of the external inguinal ring and inguinal canal is difficult because the patients' small size. Operation is the treatment of choice. The basic operation is inguinal herniotomy, which entails dissecting out and opening the hernia sac, reducing any contents and then transfixing the neck of the sac and removing the remainder.
Most common type of hernia
Always unilateral
Inguinal herniotomy is the basic operation
Transillumination distinguishes it from hydrocele