THE PATHOLOGICAL EVALUATION OF THE PEDIATRIC INGUINAL-HERNIA SAC

Background: The College of American Pathologists has suggested that in stitutions should establish guidelines for the evaluation of the herni a sac. In addition, some states require the submission of this tissue for pathological evaluation. Yet, neither evidence-based guidelines no r published reviews for the evaluation of the pediatric hernia sac are available. Therefore, this retrospective study was conducted to docum ent experience with the evaluation of the pediatric hernia sac. Method s: All reports of the evaluation of hernia sacs submitted to the Depar tment of Pathology during an 8-year period were reviewed. The case of any report that differed in any way from ''consistent with hernia sac' ' was evaluated for the effect of the findings on the clinical course. Results: A total of 7,924 hernia sacs were submitted on 6,034 patient s. Microscopic evaluation was performed on 534. A total of 7,567 (95.4 %) submitted specimens on 5,743 patients were ''consistent with hernia sac'' and demonstrated no other findings. Three hundred fifty-seven s pecimens contained findings in addition to hernia sac. in no patient d id the results of the evaluation have an effect on the patient care. C onclusions: There is strong evidence that the routine pathological eva luation of pediatric hernia sacs offers little relevant clinical infor mation. Mandatory tissue submission of hernia sacs should be reconside red. Copyright (C) 1998 by W.B. Saunders Company.