Postnatal Spontaneous Closure of the Processus Vaginalis in Preterm Infants: A Case Series

: Introduction Pediatric inguinal hernias are generally treated surgically because of the risk of incarceration; however, clinical regression has been reported, particularly in preterm infants. Whether such regression represents anatomical closure of the processus vaginalis (PV) remains uncertain. Case Series Case 1 was a male infant born at 28 weeks and 2 days who developed incarceration of a right bowel-containing inguinal hernia at 5 months. After successful manual reduction, elective repair was scheduled according to our institutional practice of performing inguinal hernia repair at or after 6 months of age. The bulge disappeared by 6 months. Laparoscopy at 7 months revealed complete PV closure. Case 2 was a male infant born at 35 weeks and 1 day with a right bowel-containing inguinal hernia diagnosed at 1 month. Elective repair was similarly scheduled. The bulge disappeared by 4 months, and laparoscopy at 7 months demonstrated complete PV closure. Case 3 was a male infant born at 25 weeks and 5 days with bilateral bowel-containing inguinal hernias diagnosed at 3 months. The left hernia became incarcerated and was successfully reduced. Elective repair was similarly scheduled. The left bulge disappeared by 4 months, whereas the right hernia persisted. Laparoscopy at 7 months showed complete left PV closure, whereas the right PV remained patent and was repaired. Conclusion A PV through which bowel herniation had occurred can spontaneously close. This potential outcome, however, is unpredictable and should not be a reason to postpone the repair of inguinal hernias in infants.