Koutsoumis Georgios, Patoulias Ioannis, Kaselas Christos
1st Department of Pediatric Surgery, "G. Gennimatas" University Hospital, "Aristotle" University of Thessaloniki, Ethnikis Aminis 41, 54635, Thessaloniki, Greece.
J Pediatr Surg. 2014 Nov;49(11):1656-8. doi: 10.1016/j.jpedsurg.2014.05.020. Epub 2014 Jul 28.
The aim of this study was to investigate the presence of a patent processus vaginalis (PPV) in children of late childhood and pre-adolescence presenting with new onset hydrocele.
All males with hydrocele presenting at our department from January 2011 to January 2013 were followed. Patients with secondary hydroceles were excluded. Demographic data, medical history, clinical symptoms and signs relative to their pathology and U/S findings were recorded. According to their indications, patients were either operated or followed up. Patients surgically treated, consisted our study group.
Sixty patients were identified. Thirteen were followed until resolution of their hydrocele. Forty-seven patients were surgically treated. Twenty-seven had right sided hydrocele (57.44%), 13 had left sided hydrocele (27.66%) whereas in 7 patients the hydroceles were bilateral (14.9%). All patients were operated by an inguinal approach. In all 9 patients (19.14%) presenting with new-onset hydrocele at the age >10 years (range: 10-15 years), intraoperative exploration did not reveal a PPV. All patients were followed at least for 6 months post-operatively.
Early evidence shows that primary new onset hydroceles presenting in late childhood and pre-adolescence seem to be non-communicating and resemble the adult type hydrocele pathology.
本研究旨在调查新发性鞘膜积液的儿童晚期和青春期前儿童中鞘状突未闭（PPV）的存在情况。
对2011年1月至2013年1月在我科就诊的所有鞘膜积液男性患者进行随访。排除继发性鞘膜积液患者。记录患者的人口统计学数据、病史、与病理相关的临床症状和体征以及超声检查结果。根据其指征，患者要么接受手术，要么进行随访。接受手术治疗的患者组成我们的研究组。
共确定60例患者。13例患者随访至鞘膜积液消退。47例患者接受了手术治疗。27例为右侧鞘膜积液（57.44%），13例为左侧鞘膜积液（27.66%），7例为双侧鞘膜积液（14.9%）。所有患者均采用腹股沟入路进行手术。在所有9例年龄>10岁（范围：10 - 15岁）出现新发性鞘膜积液的患者中，术中探查未发现鞘状突未闭。所有患者术后至少随访6个月。
早期证据表明，儿童晚期和青春期前出现的原发性新发性鞘膜积液似乎是非交通性的，类似于成人型鞘膜积液病理。
