ABSTRACT
The gonad begins to develop during the fifth week of intrauterine life. Elongation of the body stalk results in a relative caudal migration, but the first phase of the testicular descent is under the influence of Müllerian inhibiting hormone. At the lower pole of the gonad, a strand of mesenchymal cells develops into a band-like structure, which becomes the gubernaculum in the male and the round ligament in the female. The former reaches outside the superficial inguinal ring by 30 weeks’ gestation and then migrates to the lower pole of the scrotum under the influence of testosterone, while the round ligament never enters the labium. At about the eighth week of development, a peritoneal prolongation appears, passing through the layers of developing abdominal-wall muscle along the course of the developing gubernaculum or round ligament. The testis then migrates down the peritoneal canal or processus vaginalis, which is still patent at birth in about 90 per cent of children. Failure of this processus to close leads to the potential of an inguinal hernia or
• To recognize the risk of incarceration of inguinal herniae, particularly in the first year of life. • To recognize the particular points relevant to neonates. • To recognize the high chance of resolution of infantile hydroceles. • To recognize the need to identify femoral herniae. • To recognize the high chance that umbilical herniae resolve, even after the age of five years.
