Revisiting Ramonede rings in the walls of inguinal hernia sacs

Inguinal hernia repair is one the most commonly performed operative procedures in children. This author has observed ring-like structures in the walls of the inguinal hernia sacs of four patients. They were all male children in the age-group of 1-8 years. The rings were circumferentially complete and had a fibrotic cord-like appearance. A literature search for these unusual rings has revealed that similar structures have been reported very rarely in the past. In a thesis published in 1883, Ramonede described the presence of one to four peritoneal rings along the course of the patent processus vaginalis in patients presenting with a strangulated indirect inguinal hernia.