Incarcerated Inguinal Hernia in Children

Abstract

The aim of this study was to document the data of incarceration in a group of children with inguinal hernia and to investigate whether incarceration could have been prevented. Materials and methods: A retrospective study reviewed the records of 3100 children who underwent herniorrhaphy between 1989 and 2007 in one centre, with 113 patients having hernia incarceration. In 16 patients, manual reduction was not attempted because of signs of strangulation, and in the remaining ones, reduction following sedation was not successful. The patients were evaluated with respect to age, postoperative mortality, and morbidity and especially whether he or she had been scheduled for operation in a surgical department. The incidence of incarcerated inguinal hernia and risk factors were analysed. Results: Of the 113 patients with incarcerated inguinal hernia, 105 were boys (92.9%), with a male to female ratio of 13:1. The majority of the patients were under one year of age (n=73); and 47 were 0-3 months old. Three laparotomies, 7 small intestinal resection and primary anastomoses, 2 oophorectomy, 7 partial omentectomy and 8 appendectomies were performed. During the 6 months to 18 years follow-up, testicular atrophy was seen in 4 boys. Two babies died. Scrotal oedema, testicular atrophy and mortality rate were significantly higher in incarcerated hernia patients compared with those without incarceration (all with p=0.001). Conclusions: Apparently, incarceration may be a preventable problem. Priority should be given to the treatment of inguinal hernias in infants less than 1 year of age, especially those 1-3 months old, as their risk of incarceration is higher.

Incarcerated and strangulated inguinal hernias in children: A 10-year retrospective analysis

“…This is comparable to previous reports. [3,8,14] In a comparative study, Lawal et al [16] observed that infants are three times more likely than older children to develop complicated hernia. This has underlined the high risk of complicated hernias in infants and as such has brought to fore the need for early elective surgery, particularly in this category of children.…”

“…[3,9] Once an incarcerated hernia is reduced, a delay of 24-48 h is necessary to allow resolution of edema of the content of the hernial sac. [8,9] This study highlights our experience in the management of incarcerated indirect inguinal hernia in children in a tertiary care hospital in Southwest Nigeria.…”

“…[3,9] Once an incarcerated hernia is reduced, a delay of 24-48 h is necessary to allow resolution of edema of the content of the hernial sac. [8,9] This study highlights our experience in the management of incarcerated indirect inguinal hernia in children in a tertiary care hospital in Southwest Nigeria.Background: In pediatric inguinal hernia, the most feared complication is incarceration, which can lead to catastrophic consequences if not resolved expeditiously. Aims: This study assessed the usefulness of manual reduction of complicated inguinal hernia in children.…”

“…[4][5][6] Once diagnosed, early treatment on an elective basis to prevent the risk of complications such as incarceration, intestinal obstruction, and strangulation has been advocated by most surgeons. [7,8] Incarceration occurs in about 3%-18% of children with inguinal hernias. [3,9] The risk is even higher in infants, particularly those under 6 months, and premature babies.…”

Manual Reduction of Incarcerated Inguinal Hernia in Children

“…They present with a tense, tender, irreducible lump in either groin and sometimes associated with vomiting 1,2,3 . About 95% of incarcerated inguinal hernias may be reduced successfully by nonoperative maneuvers of manual reduction called taxis under sedation 4,5,6,7,8,9,10,11 . This study describes our experience of incarcerated inguinal hernia over a period of 30 months at the department of paediatric surgery in Kanti Children's Hospital.…”