Direct inguinal hernia in pediatric patient case report

Direct inguinal hernia in pediatric patient : case report of 13 -month-old infant Young Ju Hong, Seonae Ryu, Eun Young Chang and Seok Joo Han Department of Pediatric surgery, Severance Children’s Hospital, Yonsei University College of Medicine, Seoul, Korea Background Direct inguinal hernia in pediatric patient is - rare - most common presentation recurrenace after repair of indirect inguinal hernia - increasing use of laparoscopy has shown them to be somewhat more common than thought Laparoscopic hernia repair - useful in recurred inguinal hernia Case Permacolⓡ was applied to the defect site (picture 5) Using Hystoacryl ⓡ, a surgical glue, to fix on the abdominal wall. (Picture 6, 7) Right medial umbilical fold was pulled up and fixed to the Permacolⓡ (Picture 8, 9, 10) 5 An 13 -month-old boy presented with recurred right side ingional mass. Ten months ago he received bilateral inguinal hernioplasty(High ligation) at another hospital. Ultrasonography showed small amount of left hydrocele with suspicious patent vaginalis and small bowel herniated to right inguinal area. Laparoscopic approach was used to performed the operation 6 Permacolⓡ Hystoacrylⓡ 7 8 9 10 Both left and right processus vaginalis was highly ligated. (Picture 1, 2) Right direct hernia was observed at medial side of right inferior epigastric vessels. (Picture 1 arrow) 1 2 After removed hernia sac, (picture 3, 4) 3 4 After 6 months of the operation, the patient is no signs of recurrence. Conclusion We should consider direct inguinal hernia in recurred inguinal mass after high ligation Laparoscopic approach is useful in recurred inguinal hernia.