Dr. Vivek M. Rege
Pediatric Surgeon & Pediatric Urologist
B J Wadia Hospital For Children, Hurkisondas Hospital,
Wockhardt Hospital, Mumbai

This is one of the commonest conditions seen in children, more often in boys than in girls. This is noticed as a swelling in the groin or inguinal region - that increases on crying, coughing or straining. The swelling is hardly visible or decreases when the child is asleep, quiet.

Why? : During the formation of the child in the womb of the mother, both the testes in a boy are formed originally in the abdomen, just below the developing kidneys. With growth of the fetus, the testes descend down towards the scrotum. An outpouching of the abdominal (peritoneal) cavity occurs at the 3rd month of gestation (pregnancy). This pouch goes from the abdomen through the 3 abdominal muscles in the inguinal (groin) canal and down into the scrotum. This is a passage meant for the testis to follow and pass into the scrotum where it resides for the rest of its life. Normally this open passage, called Processus vaginalis, closes spontaneously after the testis descends into the scrotum. Incomplete or non obliteration of the passage gives rise to a Hydrocele or Hernia respectively. In a Hernia the intestines that are within the abdominal cavity can now come out through the muscles and descend up to the scrotum and can go back into the abdomen.(Fig 1)