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Strangulated umbilical hernias in children
1Department of Surgery, Division of Pediatric Surgery, A. Le Dantec Hospital, Dakar, Sénégal. ibrahimafall@yahoo.fr
Insights
Strangulated umbilical hernias in children are rare but require emergency surgery. This study found 41 cases needing immediate intervention, challenging conservative treatment recommendations.
Area of Science:
- Pediatric Surgery
- Abdominal Wall Pathology
Background:
- Umbilical hernia is common in children, typically resolving by age 4.
- Strangulation is a rare but serious complication of pediatric umbilical hernias.
Purpose of the Study:
- To investigate the incidence and outcomes of emergency surgery for strangulated umbilical hernias in children.
- To evaluate the current management strategies for this rare complication.
Main Methods:
- Retrospective study of 41 children undergoing emergency surgery for strangulated umbilical hernias.
- Data collected over a 5-year period (January 1997 - December 2001) at Aristide Le Dantec hospital.
Main Results:
- 41 cases of strangulated umbilical hernias required emergency surgery, representing 15% of operated umbilical hernias.
- Average age was 14 months; 5 cases involved bowel necrosis/perforation requiring resection and anastomosis.
- Post-operative complications included wound infections (2 cases) and hernia recurrence (1 case); no mortality was reported.
Conclusions:
- Emergency surgical intervention is crucial for strangulated umbilical hernias in children.
- Findings challenge the efficacy of conservative therapy in Western reports for this condition.
Abstract:
Umbilical hernia is a frequent pathology of the anterior abdominal wall in children. The hernia ring closes usually before 4 years, but a strangulation can occur. It is an exceptional complication according to the literature data. Since this complication is rare, we undertook a retrospective study of these strangulations in a 5-year period from January 1997 to December 2001 at Aristide Le Dantec hospital. We collected 41 cases that underwent emergency surgery operations for strangulated umbilical hernias, which represent about 15% of umbilical hernias operated during the same period. The age range was 8 months to 10 years and the average age was 14 months. All the children were examined within 24 h after the onset of the disease and the surgery was immediately performed. In five cases the bowel was necrosed and perforated and we performed a resection followed immediately by an anastomosis. In the follow up, two children presented wound infections and a hernia recurred in one child. There was no mortality. This study conducts us to question western reports which recommend conservative therapy for umbilical hernia in children.