Question 11: Which of the following statements are correct regarding Inguinal hernias in children?
I. It is more common in premature boys.
II. It should be repaired promptly.
III. It is always indirect.
IV. It may frequently be transilluminant.
Select the answer using the code given below :
- A. II and III
- B. I, III and IV
- C. I, II and IV
- D. I, II and III (Correct Answer)
Explanation: ***I, II and III***
- **Statement I is correct**: Inguinal hernias are significantly **more common in premature boys**, with an incidence of up to **30% in preterm infants** compared to 3-5% in term infants. Male predominance is marked (6-10:1 ratio).
- **Statement II is correct**: Pediatric inguinal hernias should be **repaired promptly** (elective basis) due to the high risk of **incarceration and strangulation**, especially in infants under 1 year where the risk can be as high as 31%.
- **Statement III is correct**: All inguinal hernias in children are **indirect hernias**, occurring through a **patent processus vaginalis**. Direct hernias are extremely rare in the pediatric population and represent adult pathology.
- **Statement IV is incorrect**: Inguinal hernias are typically **NOT transilluminant** because they contain solid abdominal contents like bowel or omentum. **Transillumination** is a characteristic feature of **hydroceles** (fluid-filled), not hernias.
*II and III*
- While statements II and III are correct, this option is **incomplete** as it omits Statement I, which is also factually correct regarding the increased incidence in premature boys.
*I, III and IV*
- Statements I and III are correct, but **Statement IV is false**. Inguinal hernias do **not transilluminate** because they contain bowel or omentum, not fluid. Transillumination distinguishes hydroceles from hernias.
*I, II and IV*
- Statements I and II are correct, but **Statement IV is false** (hernias are not transilluminant), and Statement III is omitted despite being a fundamental characteristic of pediatric inguinal hernias (always indirect).