Hernia: paediatric inguinal hernia: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Hernia: paediatric inguinal hernia

Sample item

A 6-month-old boy has a reducible right inguinal hernia that appears on crying. What is the appropriate operation?

AWatchful waiting until 5 yearsBLichtenstein mesh repairCHerniotomy with high ligation of the sac, without meshDPosterior wall reconstruction with a Bassini repair

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Herniotomy with high ligation of the sac, without mesh

Paediatric inguinal hernias are indirect, due to a patent processus vaginalis, with a normal inguinal floor. Dividing and ligating the sac at the deep ring is curative, and no repair of the posterior wall or mesh is needed. Repair is not delayed in infants because the risk of incarceration is high.

Option by option

A. Watchful waiting until 5 years
Delay carries an appreciable risk of incarceration in infants.
B. Lichtenstein mesh repair
Mesh is unnecessary because the abdominal wall is normal.
C. Herniotomy with high ligation of the sac, without mesh (correct)
Correct. The defect is the patent sac, so simple high ligation cures it.
D. Posterior wall reconstruction with a Bassini repair
Posterior wall repair is an adult operation for weak floor and is not needed.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Herniotomy with high ligation of the sac, without mesh. Paediatric inguinal hernias are indirect, due to a patent processus vaginalis, with a normal inguinal floor.

Why is "Watchful waiting until 5 years" not the answer?

Delay carries an appreciable risk of incarceration in infants.

Why is "Lichtenstein mesh repair" not the answer?

Mesh is unnecessary because the abdominal wall is normal.

Why is "Posterior wall reconstruction with a Bassini repair" not the answer?

Posterior wall repair is an adult operation for weak floor and is not needed.

What concept does this question test?

It tests Hernia: paediatric inguinal hernia in General Surgery. Dividing and ligating the sac at the deep ring is curative, and no repair of the posterior wall or mesh is needed. Repair is not delayed in infants because the risk of incarceration is high.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Hernia: paediatric inguinal hernia?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.