Morbidity and mortality of inguinal hernia in the newborn

In an 11 year period, 17 newborns aged < or = 42 days had repair of 21 inguinal hernias. Eleven 52%) of the hernias were incarcerated or strangulated, necessitating bowel resection in 4 (36%) and orchidectomy for testicular infarction in 2 (18%). Only 4 babies with 7 hernias had elective herniotomy for uncomplicated hernia. In one baby with Hirschsprung's disease (bilateral hernia) and another with anorectal malformation, herniotomy was performed at the time of initial colostomy. Postoperatively, wound infection occurred in 4 (36%) of the 11 incarcerated or strangulated hernias (3 had bowel resection). One baby who had intestinal resection died from overwhelming infection. The median hospital stay in babies with uncomplicated hernia was one day and 4 days in those with complicated hernia. The morbidity of incarcerated and strangulated inguinal hernia in newborns is high, with attendant risk of bowel gangrene and testicular infarction. The principle of early referral and repair of inguinal hernias should be encouraged to avoid such morbidity and possible mortality.