title: The risk of developing a symptomatic inguinal hernia in children with an asymptomatic patent processus vaginalis.
abstract: BACKGROUND
  Children with a symptomatic indirect inguinal hernia have a patent processus vaginalis (PPV). However, the reverse is unknown, as the natural history of PPV is unclear. Currently, there are little data regarding the incidence and time frame for developing a symptomatic hernia with a known asymptomatic PPV.
  
  
  METHODS
  A retrospective chart review was conducted in children who were evaluated for a PPV during nonhernia laparoscopic surgery by a single pediatric surgeon (GWH) from 2000 to 2014. Those patients with intraoperative findings of PPV were followed up by chart review and phone inquiry.
  
  
  RESULTS
  1548 children underwent a laparoscopic operation, with 308 having an asymptomatic PPV. Phone contact was successful in 125 (43%) of these patients at a median of 8.1years (range 4.8-12.7) after the initial laparoscopic operation. Nineteen (13%) patients returned with a symptomatic hernia at a median age of 17months (range: 5-74) and a median presentation of 9months (range: 1-66) after the initial laparoscopy. Ten hernia repairs were unilateral and 9 bilateral. None of those who were contacted via phone inquiry reported hernia symptoms or hernia repair.
  
  
  CONCLUSIONS
  These data suggest that the risk of developing a symptomatic hernia during childhood in the presence of a known PPV is relatively low.
  
  
  METHODS
  Level 3; type of study: retrospective study.
authors.affiliation: Department of Surgery, Children's Mercy Hospital, Kansas City, MO.
authors.forename: Katrina L
authors.initials: KL
authors.lastname: Weaver
authors.affiliation: Department of Surgery, Children's Mercy Hospital, Kansas City, MO.
authors.forename: Ashwini S
authors.initials: AS
authors.lastname: Poola
authors.affiliation: Department of Surgery, Children's Mercy Hospital, Kansas City, MO.
authors.forename: Joanna L
authors.initials: JL
authors.lastname: Gould
authors.affiliation: Department of Surgery, Children's Mercy Hospital, Kansas City, MO.
authors.forename: Susan W
authors.initials: SW
authors.lastname: Sharp
authors.affiliation: Department of Surgery, Children's Mercy Hospital, Kansas City, MO.
authors.forename: Shawn D
authors.initials: SD
authors.lastname: St Peter
authors.affiliation: Department of Surgery, Children's Mercy Hospital, Kansas City, MO. Electronic address: gholcomb@cmh.edu.
authors.forename: George W
authors.initials: GW
authors.lastname: Holcomb
mesh_terms: D000293:Adolescent; D058070:Asymptomatic Diseases; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D010535:Laparoscopy; D008297:Male; D010532:Peritoneal Diseases / Q000150:complications* / Q000175:diagnosis; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Asymptomatic patent processus vaginalis; Children; Inguinal hernia; Laparoscopy