الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Pediatric inguinal hernia repair is one of the most common procedures performed by pediatric surgeons however, it can be one of the most difficult procedures a surgeon will perform. In experienced hands, repair can often be performed rapidly and with a low complication rate.
The study was conducted in Pediatric Surgery Department at Alexandria University Children’s Hospital starting from 1st of January to end of June 2014.
Patients were selected according to the following inclusion criteria:
1. History of intermittent inguinal fullness alleged by the parents.
2. Patients referred by pediatrician, general surgeon or general practitioner (non pediatric surgeon) with query history of inguinal swelling.
3. Patients presented with pain in inguinal and pubic region and not sure of inguinal lump.
4. Routine rolling of contralateral spermatic cord in cases presented with obvious ipsilateral inguinal hernia.
Exclusion criteria:
1. Patients presented with obvious hernia (evident swelling).
2. Complicated or recurrent inguinal hernia.
3. Parents refused to consent.
Total number of cases included in the study was 300 cases with male to female ratio of 2:1 (200 cases 66.6%: 100 cases 33.3%) with mean age of 14.57 ± 21.96 months.
In the current prospective study all cases were examined by rolling test , 240 cases, (80%), were positive by rolling test and were subsequently operated upon, while 60 cases, (20%) were negative by rolling test and were followed up for 6 months period.
Surgical exploration revealed true hernial sac in 234 cases ,(97.5%), while 6 cases , (2.5%), did not have patent processus vaginalis. During follow up 3 cases ,(5%), developed clinically evident hernia.
The clinically applied rolling test in this series showed a sensitivity of 99.15% (male sensitivity =98.6% and female sensitivity =100%) and specificity of 90.62% (male specificity=90.2%and female specificity=90.2%).
Finally we can consider the rolling test as the simplest noninvasive preoperative diagnostic test of congenital inguinal hernia in pediatric age.
CONCLUSION
• Inguinal hernia is not always feasible to be diagnosed based on clinical finding of content within the hernia sac and in order to reach decision regarding operative intervention the surgeon may find himself obliged to rely upon other criteria.
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