الفهرس 
Contents
Metachronous Contralateral Inguinal HerniaOnly 14 pages are availabe for public view
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Abstract
Inguinal hernia remains one of the most common surgical disorders in children. Almost all pediatric hernias are indirect. The incidence of pediatric inguinal hernia is highest during the first year of life and then gradually decreases thereafter. It occurs in 1-5% of children. The incidence is higher in neonates and infants, Male: female = 7: 1. It occurs in the right side 60 %, left side 25 % & bilateral 15 %. Premature infants have an even higher risk of developing inguinal hernia with reports of incidence up to 25%. Approximately 40% of children with a clinical unilateral inguinal hernia display a patent processusvaginalis on the contra lateral side with half of these children subsequently develop a contralateral inguinal hernia. The diagnosis of inguinal hernia by clinical signs such as inguinal bulging, and thickening of the spermatic cord is usually easy (silk glove sign), but is not always possible especially in obese children.Likewise, many parents complain of observing a transient inguinal swelling in their child that could not be detected at the time of examination. Routine bilateral exploration was done regardless of the clinical findings has been practiced by surgeons for many years to avoid exposing the child to another operation with its psychological and economic impact on the family. However, routine contralateral exploration may be accompanied by a high incidence of negative exploration, unnecessary lengthening of the operative time and possible increasing morbidity in those patients In order to minimize the incidence of negative exploration of the contralateral side, several methods had been used such as diagnostic pneumoperitonium, herniography, ultrasonography and intra-operative laparoscopy. Ultrasonography represents a great option for evaluation of contralateral PPV It provides a safe, uncomplicated and non invasive, readily available method so that it can be used for evaluation of inguinal hernia and contralateral side for diagnosis of PPV.