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[Strangulated umbilical hernia in children (Burkina Faso): differences with developed countries]
E Bandré1, R A F Kaboré, A Sanou
1Service de chirurgie pédiatrique, CHU pédiatrique Charles-de-Gaulle, 01 BP 1198, Ouagadougou 01, Burkina Faso. brice52001@yahoo.fr
Insights
Complicated umbilical hernias in children, though rare, require prompt surgical intervention, especially when incarcerated. Early surgery is recommended for hernias suspicious of incarceration or with a defect diameter of 1.5 cm or less.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Context:
- Umbilical hernias are common in pediatric populations.
- Complications associated with pediatric umbilical hernias are infrequently documented.
- This study investigates complicated umbilical hernias in a specific patient cohort.
Purpose:
- To determine the incidence of complicated umbilical hernias in the study's patient population.
- To identify potential risk factors associated with these complications.
- To compare findings with those reported in developed countries.
Summary:
- Over three years, 162 children underwent surgery for umbilical hernias, with 30 (18.5%) experiencing complications.
- The complicated group, averaging 3.5 years old, frequently presented with irreducible masses (29 cases) and bowel obstruction (24 cases).
- Five patients required intestinal resection due to ischemia, and one mortality was recorded. Hernia diameter ranged from 1-1.5 cm.
Impact:
- Highlights the significant incidence of complications in pediatric umbilical hernias in the studied region.
- Suggests surgical intervention for umbilical hernias when incarceration is suspected or defect size is ≤1.5 cm, especially if follow-up is challenging.
- Provides data that may inform clinical guidelines and management strategies for pediatric umbilical hernias globally.
Abstract:
Umbilical hernias occur frequently in children but complications are rarely reported. This study assesses the incidence of complicated umbilical hernias in our patients, evaluates data for risk factors, and shows dissimilarities with those encountered in developed countries. This study reports all children operated for complications due to strangulated umbilical hernia over a period of 3 years. On the whole, 162 children had umbilical hernias treated during this period. Thirty (18.5%) of these had complicated hernias. The average age of the complicated group was 3(1/2) years. Twenty-nine cases had a painful irreducible umbilical mass. Twenty-four children had bowel obstruction, while stercoral fistula occurred in one child. The average diameter of the hernia ranged between 1 and 1.5 cm. Five patients had ischemic intestine that required resection. One patient died. When active observation and follow-up after 1 year is difficult or not feasible when the wall defect diameter is 1.5 cm or less, and in suspicion of incarceration (unexplained abdominal pain, and irreducibility), umbilical hernia should be operated.
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