The arterial duct is a short vessel that connects the junction of the main and left pulmonary artery to the descending aorta just distal to the left subclavian artery. In foetal life, it is an essential vascular structure that allows oxygenated blood to bypass the pulmonary circulation, since the lungs are not involved in oxygenation and enter systemic circulation. Persistent patency of the arterial duct after 3 months of age in term infants is a common form of congenital cardiovascular abnormality representing 5–10% of all congenital heart defects. Also, persistent patency of the arterial duct is a common problem in very premature sick neonates, which is associated with significant morbidity and mortality and is attributed to immaturity of the duct and associated co-morbidities in this population.
Part of the book: Congenital Heart Disease
The inguinal hernia is the commonest type of hernia in children. Either scheduled or as an emergency, hernia surgery is performed daily in every pediatric surgical institution worldwide, regardless of age or gender. In this chapter, we discuss the embryology of the inguinal canal and its pathophysiological association with hernia formation. We also present the most frequent clinical and diagnostic issues of the pediatric hernia. The management of strangulated hernia, differential diagnosis, and the particular uncommon hernia types are presented as well. We finally present the evolution of hernia surgery from the classical operative methods to the modern laparoscopic techniques.
Part of the book: Hernia Updates and Approaches