Do ventriculo-peritoneal shunts in children reveal the natural history of closure of the processus vaginalis?
The high occurrence of inguinal hernias and hydroceles after ventriculoperitoneal shunt insertion supports the role of raised intraabdominal pressure in the etiology of these conditions. It appears that raised intraabdominal pressure is associated with an increased incidence of clinical hernias, but not with increased incidence of patency of the processus vaginalis. The development of an inguinal hernia or hydrocele after insertion of a ventriculoperitoneal shunt can be used as an indirect marker of patency of the processus vaginalis at the time of insertion of the shunt. From this, we propose that the processus vaginalis remains patent in at least 30% of children in the first few months of life, after which time the patency rate appears to fall off quite sharply.
Hand symptoms are closely associated with latex sensitization. Questionnaires should be useful in health monitoring for HCWs who use latex gloves.