Pathologie urgente du processus péritonéovaginal chez l'enfant

Abnormal persistence of the processus vaginalis in children predisposes to two complications that are strangulated inguinal hernia, and exceptionally herniated appendix. The inguinal hernia is a frequent pathology because global incidence varies from 0,8 to 4,4 % for children of any age and reaches about 30 % in premature children. Strangulated inguinal hernia is rare (from 1,5 to 8 %) and constitutes a surgical emergency. More frequently, reduction following sedation is possible (from 25 to 33 %), and normally leads to delayed surgery. Current practice is to operate early in these children, including preterm infants, before any complication arises. This early surgery requires use of regional anesthetic techniques such as spinal anesthesia, ileo inguinal ileo hypogastric nerve blocks and caudal anesthesia. However, although this pathology may appear to be routine commonplace it requires a specialized surgical and anesthetic approach and specialized environment.