An Overview of Pediatric Inguinal Hernias: Experience at a Tertiary Care Center in Northern Province of Saudi Arabia.

Abstract

Background:Inguinal hernia repair is one of the most common pediatric operations performed nowadays. Majority are right sided indirect hernias and common in male gender. 1,2 Presentation varies from asymptomatic to life threatening complications. Operations are usually done under general anesthesia in an elective setting but the acute presentations like obstruction or strangulation are managed in emergency. Objectives:To see the clinical presentation and management outcome of congenital inguinal hernia cases who presented in the Pediatric Surgery Department of Qurrayatcentral hospital, Northern province, Kingdom of Saudi Arabia. Subjects and Methods: 4 years descriptive study of pediatric patients with inguinal hernia in Central hospital of Qurrayat city, Kingdom of Saudi Arabia, excluding patients with comorbidities or congenital malformations. Data included age, gender, clinical presentation, involvement (unilateral or bilateral), content of the sac, associated conditions, operative choice (elective or emergency) and complications after operation. Data analysis was done using statistical package SPSS version 16. Results: In 4 years, 520 patients (Male to female ratio 7:1) presented with inguinal hernia, majority less than 1 year (55%) with right sided predominance (56.5%). Undescended testis in 12(2.4%) and hydrocele in 9(1.8%) were the associated conditions. Some cases presented with contents like large intestine (5.2%), appendix (0.8%), testis (0.6%) and small intestine or ovary (0.4%) while 11.3% came in emergency as strangulated hernias. After operation, nearly all cases (98.5%) passed without complications, recurrence occurred in 6(1.2%) cases and 2(0.4%) cases were complicated by wound infection, seen in older aged patients. Sac containing large intestine or appendix presented with complications.

Introduction of Pediatric Laparoscopic Inguinal Hernia Repair in Guatemala

“…Open surgical repair with high ligation of the sac had been the standard of care in the United States but has been displaced over the last 2-3 decades by laparoscopic inguinal hernia repair in adults and, more recently, in children [1][2][3]. Unlike in adults, high ligation of indirect inguinal hernias, even in patients under 18 [5], remains the preferred repair method in pediatric patients instead of mesh placement. A signi cant advantage of laparoscopic repair in adults and children is that it allows for examining the contralateral inguinal ring, which may harbor an occult patent processus vaginalis or even a small hernia.…”