A 3-year-old male is admitted to the pediatric clinic with a palpable mass in the right side of his scrotum, and a preliminary diagnosis is made of a congenital, indirect inguinal hernia. Which of the following is the most likely cause of an indirect inguinal hernia in this patient?
Congenital inguinal hernias occur when a large patency of the processus vaginalis remains so that a loop of intestine herniates into the inguinal canal. A congenital hydrocele is also caused by a patent segment of a processus vaginalis filled with fluid, but it does not cause an indirect hernia. Ectopic testes occur when the gubernaculum does not migrate correctly during development and the testis does not reach the scrotum, but this does not cause a hernia. Epispadias occurs when the external urethral orifice opens onto the dorsal surface of the penis and is generally associated with exstrophy of the bladder. A rupture, or tear, of the transversalis fascia would not cause the intestines to herniate through the deep inguinal ring and therefore would not cause an indirect inguinal hernia.
The deep ring opens into an intact processus vaginalis.
Congenital hydrocele
Ectopic testis
Epispadias
Abdomen & Pelvis