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In Nigerian children, inguinal hernias are common, with a high strangulation risk. The processus vaginalis closes faster in Nigerian infants compared to Caucasians.
Area of Science:
- Pediatric Surgery
- Abdominal Wall Defects
- Hernias
Background:
- External hernias are a significant concern in pediatric surgical practice in Nigeria.
- Inguinal hernias represent a substantial portion of these cases, with specific laterality patterns observed.
Purpose of the Study:
- To analyze the characteristics and outcomes of external hernias in Nigerian children.
- To compare the incidence and obliteration rates of the processus vaginalis with Caucasian data.
Main Methods:
- Retrospective review of 510 pediatric surgical cases over 10 years.
- Analysis of hernia types, laterality, incarceration, strangulation, and patent processus vaginalis (PPV).
Main Results:
- Right inguinal hernia (RIH) was most common (54%), followed by left inguinal hernia (LIH) (35%) and bilateral inguinal hernia (BIH) (9%).
- A 4% incarceration rate was noted, with a high 75% strangulation rate.
- Patent processus vaginalis (PPV) was found in 31% of cases undergoing contralateral dissection, with age-dependent obliteration rates faster than in Caucasians.
Conclusions:
- Nigerian children exhibit distinct patterns in inguinal hernias, including a lower female incidence and higher LIH rate.
- The processus vaginalis obliterates more rapidly in Nigerian infants, potentially influencing hernia development.
- Umbilical hernias present a significant risk of obstruction/strangulation in this population.
Abstract:
External hernias as seen in Nigeria constitute a major aspect of paediatric surgical practice. A review of 510 cases seen over a period of 10 years showed that, of those with inguinal hernia, 54% had right inguinal hernia (RIH), 35% left inguinal hernia (LIH), 9% bilateral inguinal hernia (BIH) and 2% hydroceles. There was a 4% incarceration rate which was, however, associated with a high (75%) strangulation rate. Thirty-one per cent of those who had contralateral groin dissection had patent processus vaginalis. This was age-dependent, ranging from 60% at 3 months to 28% at 1 year; only a half of these are likely to present with clinical hernia later in life. The incidence of umbilical hernia in the population is not known, but 35% of those who present for treatment do so because of obstruction/strangulation. Two patients had paraumbilical epigastric hernia and one a transverse incisional hernia in the left lower abdominal quadrant. On comparing our findings with Caucasian-based data, it was observed that Nigerian children had a lower female incidence of inguinal hernia, but a higher incidence of LIH, and that in them the processus vaginalis obliterated more often and at a faster rate than in Caucasians.