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Year : 2016  |  Volume : 5  |  Issue : 1  |  Page : 31-34

Differences in the development of the processus vaginalis between children with undescended testis and inguinal hernia

1 Second Department of Pediatric Surgery, Aristotle University of Thessaloniki, General Hospital Papageorgiou, Nea Efkarpia, 56403, Thessaloniki, Greece
2 Department of Pathology, Aristotle University of Thessaloniki, School of Medicine, University Campus, 54124 Thessaloniki, Greece

Correspondence Address:
Dimitrios Sfoungaris
Second Department of Pediatric Surgery, Aristotle University of Thessaloniki, General Hospital Papageorgiou, Thessaloniki Ring Road, Nea Efkarpia, 56403, Thessaloniki
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2249-4847.173270

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Background: It has been shown in several investigations that smooth muscle cells (SMCs) are present on the patent processus vaginalis (PV) peritonei in cases of inguinal hernia (IH) preventing its obliteration. The PV fails to obliterate in cases of undescended testis (UT) as well, but without causing herniation. Materials and Methods: We conducted a case control study in order to compare the status of the SMCs present on the PV in UT and IH cases and correlate it with the clinical outcome of herniation. Specimens were harvested from the hernia sacs of 26 boys with IH aged from 2 days to 16 years (mean 44.31 months) and the PV of 14 children with UT, aged from 13 months to 13 years (mean 30.28 months). They were examined histologically and immunohistochemically for markers of mature SMC such as smooth muscle actin (SMA), desmin and h-caldesmon as well as for vimentin, an immature SMC marker. Results: The expression of SMA, desmin, and h-caldesmon was present in all cases of IH and UT. Vimentin was expressed in 13 out of 14 (93%) UT specimens and in 12 out of 26 IH sacs (46.1%), (P = 0.0102). In IH and UT cases, when vimentin was not expressed, SMCs were organized in bundles. Conclusion: The SMCs on the PV in UT cases reach a more advanced stage of dedifferentiation that corresponds to a status more close to that of the natural obliteration, compared to IH cases, preventing herniation to occur.

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