Hi, this is Tom, and in this episode I'm going to be going through ingranal hernias in children.

And you can find notes at zero to finals.com and in the zero to finals pediatrics book.

And you can find flashcards and questions at members.0.0 tofinals.com. And at the end of this episode, we'll go

through some questions so you can test yourself on what you just heard. So let's jump straight in.

An inguinal hernia is where the bowel herniates through the inguinal canal. They're more common in preterm infants and in males.

It's usually diagnosed within the first year of life.

Let's go through the pathophysiology.

The inguinal canal is a tube that runs between the deep inguinal ring,

which is where the ingranal canal opens into the peritoneal cavity, and the superficial ingranol ring, which is where it

opens into the scrotum in males. In males, the ingranil canal contains the spomatic cord.

During fetal development, the Processus vaginalis is a pouch of the peritoneum that extends from the abdominal cavity through the ingranal canal and into the scrotum.

The testes descend through the Processus vaginalis.

Normally, the Deep Inguinal ring closes after the testes descend through the ingranial canal,

and the Processus vaginalis is obliterated. In some patients, the deep inguinal ring remains patent and the processus vaginalis remains intact.

This leaves a tract or a tunnel from the abdominal contents through the ingrenal canal and

into the scrotum.

The bowel can herniate along this tract, creating an

indirect inguinal hernia. Next let's go through the presentation. The main presenting

feature of an inguinal hernia is a soft lump in the groin or the scrotum.

This may be more noticeable when the infant is crying or upright.

Most infants are otherwise asymptomatic and less complications occur.

The contents of the hernia should be reducible back through the ingranial canal by applying

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