Management of inguinal hernia with prolapsed ovary in very low birthweight infants during neonatal intensive care unit hospitalisation

Abstract

Aim: Prolapsed ovary (PO) in an inguinal hernia (IH) may cause torsion and infarction; however, the management of IH with PO in very low birthweight (VLBW) infants during neonatal intensive care unit (NICU) hospitalisation remains inconsistent. Methods: The medical records of 47 IHs in 30 VLBW infants during NICU hospitalisation between 2008 and 2017 were reviewed retrospectively. Results: Of the 47 IHs, PO was diagnosed in 18 (38.3%). Post-natal age and body weight at diagnosis of IH with PO were 71 (44-172) days and 2120 (1305-2965) g, respectively. Seventeen IHs with PO underwent surgery for correction electively just before discharge from the NICU at the age and body weight of 94 (51-187) days and 2645 (2340-2945) g, respectively. Therefore, the time interval between diagnosis and surgery was 15 (7-90) days. There was no torsion of ovary before surgery and no postoperative complications, including apnoea and recurrence. Conclusions: The high incidence of IH with PO in VLBW infants during NICU hospitalisation was confirmed in this study. Under careful observation, elective IH repair just before discharge from the NICU could be one acceptable option for the management of IH with PO in VLBW infants during NICU hospitalisation to prevent torsion and infarction of ovary. Clinical course Age or body weight Post-natal age at diagnosis, days, median (min-max) 71 (44-172) Corrected age at diagnosis, weeks, median (min-max) 38 weeks 6 days (35 weeks 4 days-48 weeks 1 days) Body weight at diagnosis, g, median (min-max) 2120 (1305-2965) Post-natal age at surgery, days, median (min-max) 94 (51-187) Corrected age at surgery, weeks, median (min-max) 41 weeks 6 days (37 weeks 1 days-52 weeks 0 days) Body weight at surgery, g, median (min-max) 2645 (234-2945) Post-natal age at discharge, days, median (min-max) 102 (59-203) Inguinal hernia with prolapsed ovary M Kurobe et al.

Association of pediatric inguinal hernia contents with patient age and sex

“…In contrast, in the female patients younger than 12 months, the most common hernia content was the ovary, accounting for 90% of cases. Previous studies have shown that IH with a prolapsed ovary was often seen in the first 2 years of life, 17,18 which was supported by the findings of the present study. The ovary must therefore be recognized as the organ most likely to herniate in females, and not the bowel as seen in males.…”