Inguinal hernia repair is one of the most common surgeries performed on children. However, the value of routine histologic examination of hernia sac tissues continues to be debated. Although the surgical pathology of herniorrhaphy tissues is usually simple, occasional examples have unexpected findings that potentially lead to inappropriate management or that have added clinical implications. These along with surgical-quality assurance issues need to be considered in cost-benefit arguments. This article reviews basic histology, common potential pitfalls, and significant unexpected conditions encountered in the surgical pathology of the inguinal hernia sac in children.
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