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Incarcerated inguinal hernia in premature babies--a report of two cases
M E Coren1, N P Madden, M Haddad
1Department of Neonatology, St. Mary's Hospital, London, UK. m.coren@ic.ac.uk
Insights
Delayed surgery for inguinal hernias in very low birthweight (VLBW) infants can lead to serious complications. This case report questions the standard practice of delaying surgical intervention for VLBW infants with inguinal hernias.
Area of Science:
- Neonatal surgery
- Pediatric surgery
- Surgical outcomes in premature infants
Background:
- Inguinal hernias are common in very low birthweight (VLBW) infants.
- Current policy often delays surgical repair pending infant growth and respiratory improvement.
Observation:
- Two cases of VLBW infants with diagnosed inguinal hernias are presented.
- Surgery was delayed in both cases according to standard neonatal unit policy.
- Both infants experienced significant morbidity due to acute hernia incarceration.
Findings:
- Delayed surgical repair of inguinal hernias in VLBW infants is associated with substantial morbidity.
- Acute incarceration occurred despite delayed surgical intervention.
Implications:
- The optimal timing for inguinal hernia repair in VLBW infants warrants re-evaluation.
- Current delayed surgical practices may need reconsideration to prevent complications.
Unlabelled:
We highlight the morbidity of incarcerated inguinal hernia in very low birthweight (VLBW) infants by presenting a report of two cases. Our aim is to raise the question of the optimal timing of surgery when this common problem presents on the neonatal unit. In each of our cases the hernia was diagnosed but surgery was delayed, as per normal policy on the unit, pending growth of the baby and improvement in respiratory status. Both babies suffered significant morbidity when the hernias subsequently became acutely incarcerated.
Conclusion:
In conclusion, we question whether the widespread practice of delayed surgery for inguinal hernia in VLBW infants should be reconsidered.
