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Could incarceration of inguinal hernia in children be prevented?
Jerzy Niedzielski1, Rafał Kr l, Aleksandra Gawłowska
1Department of Pediatric Surgery and Oncology, Medical University of Lodz, Poland. jniedzielski@alef.am.lodz.pl
Insights
Congenital inguinal hernias in children can lead to incarceration, a serious complication. Many first-time incarcerations could be prevented with timely intervention, reducing the need for emergency surgery.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Public Health
Background:
- Congenital inguinal hernias are common in infants and children.
- Hernia incarceration poses significant risks, including surgical emergencies and complications.
Purpose of the Study:
- Determine the incidence of incarceration in pediatric congenital inguinal hernias.
- Identify factors contributing to hernia incarceration and assess preventability.
Main Methods:
- Retrospective analysis of 1582 pediatric inguinal herniorrhaphy cases (1993-2000).
- Evaluation of hernia incarceration timing and circumstances.
- Assessment of manual reduction success and subsequent surgical repair.
Main Results:
- 9.7% of children (153/1582) experienced hernia incarceration.
- Over half of incarcerated hernias (52.9%) occurred in infants under one year old.
- Complications, including intestinal necrosis, occurred in 10.4% of incarcerated cases.
Conclusions:
- Over half of initial inguinal hernia incarcerations in children could have been prevented.
- A significant portion of second incarceration episodes could also be avoided.
- Timely management and parental education are crucial for preventing incarceration and its complications.
Background:
The aim of this study was to determine the incidence of incarceration in children with congenital inguinal hernias and to ascertain if incarceration could have been prevented.
Material/Methods:
Records of 1582 children who underwent inguinal herniorrhaphy between 1993 and 2000 were analysed regarding the time and circumstances of hernia incarceration.
Results:
Incarcerated hernia developed in 153 cases (9.7%) developed, of whom 81 (52.9%) were known to have had prior hernia incarceration and 81 (52.9%) were under one year of age. Manual reduction of hernia was successful in 130 cases (85%), and 99 of them (76.2%) underwent hernia repair during the same stay. Emergency surgery was necessary in a total of 36 children (23.5%), 23 with the first and 13 with the second incarceration episode. Complications occurred in 16 children with incarcerated hernia (10.4%), including intestinal necrosis, omentum and appendix infarction, infarction of the testis, torsion of the ovary, recurrent hernia and wound infection.
Conclusions:
The first incarceration of known inguinal hernia could have been avoided in more than half of our patients and the second in one-fourth after successful manual reduction.