RT Book, Section
A1 Aiken, John J.
A2 Rudolph, Colin D.
A2 Rudolph, Abraham M.
A2 Lister, George E.
A2 First, Lewis R.
A2 Gershon, Anne A.
SR Print(0)
ID 7036844
T1 Chapter 405. Inguinal and Other Hernias
T2 Rudolph's Pediatrics, 22e
YR 2011
FD 2011
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-149723-7
LK accesspediatrics.mhmedical.com/content.aspx?aid=7036844
RD 2024/04/25
AB Three  distinct  anatomic  types  of  inguinal  hernias  are  observed  in  children:  congenital  or  indirect  (99%),  direct  (0.5%),  and  femoral  (<  0.5%).1  The  classic  congenital  indirect  inguinal  hernia  results  from  a  patent  processus  vaginalis,  which  represents  an  opening  from  the  peritoneum  into  the  inguinal  region  (Fig.  405-1).  Other  hernias  that  occur  in  children  include  incisional  hernia,  which  occurs  when  abdominal  viscera  protrude  through  a  previous  surgical  incision,  and  umbilical  hernia,  which  is  discussed  below.  Diaphragmatic  hernia  is  discussed  in  Chapter  50.  Epigastric  hernia  are  rare  in  children.  They  protrude  through  the  linea  alba  above  the  level  of  the  umbilicus  and  appear  to  develop  through  one  of  the  foramina  of  egress  of  the  small  paramidline  nerves  and  vessels  or  through  an  area  of  congenital  weakness  in  the  linea  alba.  About  3%  to  5%  of  the  population  have  epigastric  hernias.  They  are  more  common  in  men  than  in  women  and  most  common  between  the  ages  of  20  and  50.  About  20%  of  epigastric  hernias  are  multiple,  and  about  80%  occur  just  off  the  midline.