Which of the following applies to the defect emerging from residual peritoneal fluid confined within the lower segment of the processus vaginalis?
A. Inguinal hernia
B. Incarcerated hernia
C. Communicating hydrocele
D. Noncommunicating hydrocele
Correct Answer: D. Noncommunicating hydrocele
With a noncommunicating hydrocele, most commonly seen at birth, residual peritoneal fluid is trapped within the lower segment of the processus vaginalis (the tunica vaginalis). There is no communication with the peritoneal cavity and the fluid usually is absorbed during the first months after birth.
Option A: An inguinal hernia arises from the incomplete closure of the processus vaginalis leading to the descent of an intestinal portion. An inguinal hernia is an opening in the myofascial plain of the oblique and transversalis muscles that can allow for herniation of intra abdominal or extraperitoneal organs.
Option B: Incarceration occurs when the hernia becomes tightly caught in the hernia sac. At times an inguinal hernia can present with severe pain or obstructive symptoms caused by incarceration or strangulation of the hernia sac contents. Femoral hernias should always be repaired as they have a high risk of incarceration.
Option C: A communicating hydrocele usually is associated with an inguinal hernia because the processus vaginalis remains open from the scrotum to the abdominal cavity. The tunica vaginalis is a potential space for fluid to accumulate, provided the proximal portion of processus vaginalis remains patent and results in free communication with the peritoneal cavity, leading to congenital hydrocele.