Effectiveness of Silk-glove Test in the Contralateral Exploration of Inguinal Hernia in Children

Koo, Bon Yong; Kim, Jae Chun; Jeong, Yeon Jun

Abstract

Inguinal hernia is one of the most common surgical diseases in pediatric patients. But the management of the side opposite the clinically apparent inguinal hernia, the "silent side" is controversial. Four hundred fifty-eight cases of pediatric inguinal hernias, operated by one pediatric surgeon at the Divisionof Pediatric Surgery, Department of Surgery, Chonbuk National University Hospital from January 1998 to December 2002, were reviewed retrospectively to determine the characteristics and significances of the silk-glove test on the side opposite the clinically apparent inguinal hernia. Males were preponderant as 2.8:1. Allhernias were of the indirect type and were repaired by high ligation of the sac. There were 238 (52.0%) right sided hernias, 160 (35.0%) were on the left and 60 (13.0%) were bilateral. The number of patients with a positive silk-glove sign on the contralateral side was 158(39.7%), and 133 of these had a contralateral patent processus vaginalis. Positive predictive value of Silk-glove test was 84.2% (133/158). The silk-glove test is a simple, safe, and relatively accurate method for contralateral exploration in the unilateral inguinal hernias in children.