Congenital Hernia& Hydrocele

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A hydrocele is a collection of fluid within the processus vaginalis (PV) that produces swelling in the inguinal region or scrotum. An inguinal hernia occurs when abdominal organs protrude into the inguinal canal or scrotum. Inguinal hernia and hydrocele share a similar etiology and pathophysiology and may coexist. In the healthy male neonate, the testicle is surrounded by a closed cavity—the tunica vaginalis (TV) of the scrotum. In postnatal life, this is a potential space that should not communicate with the peritoneal cavity of the abdomen. Congenital hernia and hydrocele share a common aetiology, that is, patent processus vaginalis (PPV). PPV is an outpouching of the peritoneum through the deep inguinal ring, which closes spontaneously after testicular descent. Failure of closure of PPV leads to an abnormal communication between the abdominal cavity and inguino-scrotal region.
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Hydrocele is the collection of fluid in scrotum and swell and hernia us protrusion of omentum or gut or both contain inva sac formed by peritoneum into scrotum or above scrotum . Clinically Hydrocele in the scrotum and hernia may be in scrotum or above scrotum Tabs illumination test positive in hydrocele and in case of hernia negative Cough impulse no cough impulse in hydrocele , cough impulse us positive in hernia. Hydrocele cystic to feel Hernia may be different not cystic to feel Reducibility. Hydrocele not reducible Hernia reducible in case of reducible hernia.
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Similarity between congenital hydrocele and congenital hernia 1) Both are caused by patent processus vaginalis 2) In both abdominal content descend on tunica vaginalis around testis Differences are 1) Congenital hydrocele contain fluid congenital hernia contain bowel loop 2) Congenital hydrocele may become irreducible but congenital hernia is most of the time reducible 3) Congenital hydrocele surgery can be performed electively, but congenital Hernia surgery need to be performed as early as possible
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Illumination test is positive in hyrocele. But they all accir due to patent procesus vaginalis. It may be filled with fluid initially if no bowel herniated. But in hernia upon palpation you cant go above swelling. While on cong hydrocele you can go above the swelling.
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Both can be congenital fluid in scrotum is primary vaginal hydrocoele if intestinal prolapsed in scrotum at birth isindirect ingiumoscrotal hernia & if prolapsed uptill inguinal region then inguinal hernai
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Hydrocele is the collection of fluid in PV that produces swelling in inguinal region and scrotum. Whereas, cong.hernia occurs when abdominal part protruded in the inguinal canal or scrotum. These may coexist.
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In small babies. Transillumination test may confuse. Since sometimes it can b positive in hernia. Though hernia appears n disappears. For example when baby cries. Best way is to take Usg support.
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In hydrocoele there is clear fluid filled sac around testis painless. An inguinal hernia occurs when abdominal organs intestine/omentum protrude into inguinal canal or scrotum
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Torch test transillumination... Hernia becomes prominent on straining,crying, and upright posture...
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both a hydrocoele and an indirect inguinal hernia are the result of a patent processus vaginalis. In the case of a hydrocoele, the patent processus is small and only fluid from the peritoneal cavity will be able to pass down the potential space. A communicating hydrocoele is a fluid-filled sac that appears as a transilluminant swelling around the testis (true hydrocoele) as there is continuity between the processus vaginalis and tunica vaginalis. The main differential of a transilluminable swelling is bowel within the processus vaginalis. If the swelling occurs adjacent to the spermatic cord then this is termed an encysted hydrocoele. There may be a history of the hydrocoele appearing to enlarge during the day and then disappearing at night. This relates to the effects of gravity on filling the hydrocoele. The communication between the fluid-filled sac and the inguinal ring is so small in a hydrocoele that is is difficult to detect clinically in a congenital inguinal hernia, the proximal opening of the processus is wide. Historically, there may a story of abdominal pain, constipation, nausea or vomiting; these are indicative of incarceration or strangulation of the hernia. Clinically, it may present as a lump in groin when the intraabdominal pressure rises e.g. when the child cries, or as a persistent swelling extending from the groin to the vulva or scrotum. With a hernia, the communication can be palpable so that one could ascertain whether the lump originates from the deep inguinal ring. This manoeuvre can be painful to the patient. Hernias do not transilluminate unless they contain thin-walled bowel. An examiner cannot feel a superior border to a hernia on palpation. Bowel sounds on ausculation over the mass are virtually pathognomic of a hernia
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