Spontaneous closure of a patent processus vaginalis: a case report

Patent process vaginalis and inguinal hernia are prolific in infants, and their repair is a common pediatric surgical procedure. However, there is a paucity of direct evidence detailing the spontaneous closure of patent processus vaginalis. A 4-month-old boy born prematurely at 34-weeks with low gestational birth weight, underwent laparoscopic gastrostomy tube placement for oropharyngeal dysphagia and was incidentally found to have bilateral patent processes vaginalis. Due to his lack of symptoms, he was managed under the watchful waiting approach. His parents were educated about signs and symptoms of inguinal hernia and were instructed to contact the team with any concerns. He represented at 6 years of age with symptomatic right-sided inguinal hernia, and during planned laparoscopic surgical repair, he was found to have spontaneous closure of the processus vaginalis on the left side. His right sided hernia was repaired, and his left side was left untouched. The patient tolerated the procedure well and has had no signs nor symptoms of right sided recurrence nor new onset of left sided hernia to date. He will follow up as needed if there are any concerns for hernia on the left side. Patent processus vaginalis may progress to symptomatic inguinal hernia or may close spontaneously. Patients with bilateral patent processus vaginalis may exhibit a different outcome on each side.