Cremasteric muscle hypertrophy accompanies inguinal hernias in children.

Abstract:

PURPOSE:The physical finding of a thickened spermatic cord as indicator of an inguinal hernia in children is well documented. This thickening has been attributed to the presence of a hernia sac. Based on our clinical observations, cremasteric fibers appeared thickened in the presence of an inguinal hernia. The authors postulated that hypertrophy of cremasteric fibers contributed to the physical finding of cord thickening. METHODS:The authors evaluated 18 patients ages 5 months to 9 years, 17 boys and one girl. Each patient was found to have a unilateral inguinal hernia with palpable thickened cord on the affected side. The contralateral side contained no detectable hernia or palpable cord thickening. Each patient underwent repair of the clinical hernia and exploration of the contralateral groin. Cremasteric fiber biopsy sections were taken from both sides for cross-sectional measurement and comparison. The biopsy specimens were evaluated by a pathologist unaware of the hypothesis. RESULTS:In 15 of 18 patients microscopic measurement of the cremasteric fibers showed hypertrophy on the side of the clinical hernia when compared with the contralateral side. The contralateral side was found to have either no hernia or a small patent or obliterated processus vaginalis. CONCLUSION:The authors conclude that the palpable thickening of the spermatic cord, the "silk glove sign," in most cases is caused not only by an empty hernia sac but also by hypertrophied cremasteric muscle fibers.

journal_name

J Pediatr Surg

authors

Brisson P,Patel H,Feins N

doi

10.1016/s0022-3468(99)90002-7

subject

Has Abstract

pub_date

1999-09-01 00:00:00

pages

1320-1

issue

9

eissn

0022-3468

issn

1531-5037

pii

S0022-3468(99)90002-7

journal_volume

34

pub_type

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